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� � -- i <br /> � PERMIT APPL..ICATION <br /> I CITY OF EVERET7 PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVEF[TT, WA 98201 <br /> h?.5-257-881C — FAX 4'L5-257-8ft57—�wnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTEQ FROM N AM TO R PM <br /> PaRCEL TAX I D.k ' PERMIT� <br /> � S'0�0 I �� I�L �,�; 00�`1����bbL� 0 �m �� o z -�� � <br /> '4EGA LOT NO. BLOCK TRAC7 OR SUBOMSION# I <br /> I]ESC — <br /> �. U ER � �ADORESS GITV2IP PHONE <br /> _� 7 � �_�___ �e,�"_.�— _— .5 •�'\ � ����� <br /> TCNnNT NA�nE \CONTACT FOR P[RMR PHONE � D�y �y� w�OG <br /> I�,.1�U� Z (L, �Ll�'�J-.(l E-MAIL..�^�1�'�.l L.L;� '�A'�Q^'1 � <br /> CbRYftAGi[J �-a-lY\ oH�ssy�c� `j l ' � �5" -i�iZIP �NE �`-�v�� , . <br /> �t t,s�,v�s.-.� � (�L. �-l-E l-z �Cli ��1�` �L1 C c',c� <br /> cot+Ta, ucense a %� \ n � �� t�lti 6 <br /> V�:,t^vYl`�'�A`'1�-` �� �1 <br /> I USE OF OU�LDING I HEAT SOURCE I CON7RnCT PRICF OF YJORK <br /> --�Y� '�� _E'ectr�c ��a:_Other '� �� `��j I <br /> WORK�ESCRIPTION <br /> ( �. �C .� � � I S-� �'�j C�a � �Y ��a C .�. � Ux��' �^-.�9�--�' <br /> I � _ <br /> — PLUMBING MEC{iANICAL I <br /> Np� I •fYpE or FIX7URE OR iTE�a NO-I TYP@ OF FlXTl1RF OR ITEM — �, <br /> I <br /> —T T,�ip; NC—aii h�ndGng urots I <br /> I = Bnhtub � Forrnd eir systcm; �, <br /> --I L3vflt0ry P+rach bosin) — Gns P�P��9 � <br /> Shower _L, Water heater I <br /> . Kdehen cinfc&disposal Gas fircplacc <br /> Oish��.�sher _ Gas rarge I <br /> Ciothas washer _ Clothas drycr <br /> Watnr ha�ter Hange h0od <br /> � Slnk (snrncerbarlmop'etc) _ Fxhaust�an <br /> Oackliow preventer _ Hoal pump <br /> � Unnal Urit hcater <br /> � _ Drink�ng Pountain __ Boilc I <br /> I _ Floor drain _� Refri6emUon <br /> Grease tfap Wcedstove <br /> Root drr��ns Olhcr_._ � <br /> _ Othor _ I <br /> — �I --- — <br /> Cnr OF EVERETT LOCAL SALES TA7c CODE IS 310i � <br /> I hereby CeN�y Uiat I hove rood ond ezammed[his applicaUcn and knv:�Ihe same lo be lrue and correr,t. All provisans of lavh and <br /> ord�nanco3 governirg this rype o`«roY�c vnll he complied�vilh�vhether^,ped�5ed herein ornot The Annfinp of n pertnit do� rot prcsume <br /> to grve authoriry to vlolate or eanwl lhe pmvision oi any�lhar state ar local law re{�ulatini� eonsWetion er lhe pertomiance of <br /> � conclll.ctien. Thal I am authonr. d by ihe awner o(lhie property�v pCrf n*+thr. wcrk fo�v,hic�application •�3 maCo and I comply vnllt lhe <br /> I Sfate ontndars Law 18 27 xnd 2 6.� 200 WAC. <br /> / � � � <br /> , <br /> ' oture of `wneNConVn r!A onzna�gent Dot � <br /> v <br /> l —_ <br /> -- - - _ —.� <br />