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P =RMIT APPLICATION <br /> CITY OF EVERE7T PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 -www.everettwa,org <br /> APPLICATIONS AR[ACCEPTE� FROM 8 AM TO 4 PM . �a_�i,( _�I <br /> SJ�T�G ADDRE�S� �G� PARCEL TAX I.D.# PERMIT i <br /> 1'+ L 1�-�-�� �D <br /> LEGAL �.Oi N0. BLOCK TRACT OR SUBDIVISION qt . <br /> D�SC. <br /> OWNER ADDHE98 � GITY2IP PHONE � <br /> �1-�- �JZ��i I�'�1 � �V �1}-- '�1�2� �e.S=C1`61� <br /> I h In�.1� <br /> i �n ■ . r <br /> TENANTNAME I CONtAC7fORPERMiT PHONE <br /> [-MAIL <br /> ��'� DVl �'LIU.fi �I� �(��1� f�iJG�C�II� wA�) �l�-i-�g2�� �I�l���?- <br /> ON7R.LI' NSE iF y�� <br /> �Y <br /> US8 Of- BUILDING HEAT SOURCG CONTRACT PRICC- OF WORK <br /> �Eloctric �Gas_O�hor y t UV O <br /> WORK OESCRIPTIdN <br /> 1Y L J��� ` '� U _ �V��� <br /> PLUMBING MECHANICAL <br /> pp. TYPE OF FIXTUR[OR IT[M � NO, TYPE OF PIY.7URE OR 17EM <br /> 7oilot AIC-alr handling units <br /> Bathtuh � Farced alr systoms <br /> _ Levatory(wash basln) _ Gas plp(ng <br /> Shnwor Wator healer <br /> �� {<itchon sink&dieposol Gaa fireplace <br /> � Dlshwashor � G�s r�npo , <br /> Clothe,wflsher _ Clothps dryar <br /> Waler hoator Ranpr, hood - <br /> Sink(servlce/bar/mop/olc.) _ Exhousl(an <br /> Dackflow preventer Heat pump ���� <br /> Udnal _ UNt hoater <br /> � Drinking Fountaln Boiler <br /> ^ Floo�draln � Ratn�eration <br /> ` Groeso trap T Woodstovo . <br /> � Roof dralns � Olhor <br /> Olher .._ — <br /> CITY OF EVERETf LOCAL SALGS TNC CODE IS 3105 <br /> I horohy coritify lhat I hav rcad And oxamined thls applicollon ond know tho same to be true enA correct. All provisions of laws 0nd <br /> ordlnacos qovominp Ihls po of vro�k will ba compliad�rith whother specKee hereln or no�Tho grantlng ot a permit does not Drosume <br /> io givo aulhoriry to violate o ancofj Iho provlslon of ny other stalo or locol law regul3ting conslrucUun or ltio performanca of <br /> conatruction.TF�at I am authoriz y thc owncr of is prop rty to porfo tho rk lor whlch appllcotion is mada and I comply wl0i the <br /> State Conlract6io Law 18.2?'(2G d 2 .¢200 W C, ' �� ' <br /> \ v <br /> SiE�haWfootO oflCo raeo Aui[7nt dAgent ote . <br /> l <br /> �, �'d ZS���:���S��-bT :01 �ld0bd �b�UGJ LiO�-£-911y <br />