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F . oi <br /> F2b-27- 12 08= 14A <br /> ._ _.__ ----- --____ �._.._- - --� <br /> I PERIVIi� APPLICAT�ON ' <br /> CITY OF EVEREI'7 P�RMIT SERVICES I <br /> 3200 CEDAR STREET, EVERE77, WA 98201 <br /> 425-257-E810 - FAX 42.5-257-�857 -www.everetlwa.ory I <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � <br /> SITE ADDRESS PAF:CEL TA7C I.D.q PERMIT# <br /> � 3I cs 3 � 7`/ �'�` I (�'1�'�0� a-I`�_ I <br /> J8`ti(LI LOT NO. BLOCK TRACT OR SUBOIVISION C <br /> OWNER �� 40[]RESS CITYlZIP PNONE I <br /> n �- <br /> ��h � ( �; � �;�. � 30J �f� ST �`�`c�� ��C / ��Z�=�/7- `l<'/ 71 <br /> TENANTNAME CON7ACTFOfipERM1T PNONE <br /> EJ`1G1L <br /> GONTRAGIUR �� �� DR[55 .�c,� PNO��— <br /> ` ��v �2 c �t� �� <� &� y �- si i,�/ <br /> � !p'//A`�` .i?i'/N5. ,� � /� � /. � � !`�.L"/ z !J _ J � <br /> CON�LICENSE N i <br /> L /� � r�/V�I�.YzK L I <br /> USE OF BUILPING HE��7 SOURCE CONTRACT PRICE OF WORK <br /> /�' �r � <br /> /� �'S� ��[leclric _Gas_Olher �l,�'�' �. <br /> WORK DESCRIPTiON y � I <br /> � <br /> �: G / /f'.'.'i C�i''�L��i���� �I <br /> � �.. i <br /> � � PLUMBING MECHANICAL ��� <br /> i NO. iYPE OF FIXTURE OR ITEM � NO. TYPE OF FUCTURE OR ITEM <br /> I oilc� � A/C-air handlinp unils <br /> � ____ Bathwt, _ Forced air systems <br /> _ Levalury pvash pasin) Gas piping <br /> ', . S'huwer � Waterhealar ' <br /> Kitchcn .^,ink 8 dis�>usel �-�— � Ga5 firepl8ce <br /> I __ uisnwasher _ Gas range � <br /> Clothos w2sher Clolhes dryer <br /> ' __ � v��atcr heater Ran90 hood • <br /> � _ SinY. (service/badmop/�lc.) � Erhau9t 1an <br /> _ __ � B�ckflotiv prevontor � HCOt pump <br /> I ,_. Urinol _ Unit heator <br /> =I Drinking Pountatn . — Boiler <br /> �Wor Urain � Rofrigeralion i <br /> ___ Creuse Irap WOOdsbve <br /> � _ Roof drains � Othgf <br /> Other <br /> _ . . _.._ .....__ � — . I <br /> .--'-' __ ._� � <br /> • CITY OF fiVERETT LOCAL SALE9 TAX COOE IS 9105 <br /> I hereby ceritify that I have read and examinntl this applicalion and i;now Iho samo to bo lrue and correcL All provisions of I�ws and <br /> ! urdinaces yuvurning this rype ol work will be compiied wilh whelher speci�ied hereln or nOL Tho granlinp of a permit tloes not presurne �, <br /> lu yive authority to violale or cancel Ihe provision of any other stata or local law regulaling conslruclion or the performance ot � � <br /> conslruclion. 1'h�l I am authodzed 6y the ownor oi this proporty to F�er(orm Iba work for which application Is made and I comply with ll�e � <br /> Slale Conlrac�nrs Law 18.27 RCN' and 29G.2UU WAC. � <br /> ���1��.��.n�> � - � 7- iZ � <br /> Sl�nahire of Owner CaiM�atlo�/Aulhorized Agont Date i <br /> � ____ <br /> !. _... .___—.. . . . _... .—_ � <br />