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� <br /> ` PERMIT APF�LICATION <br /> CITY OF EVERFTT P�RMIT SERVICES ' <br /> 3200 CEDAR STREET. EVFRETT. WA 98201 <br /> 425-257-8810 -- FAX 425-257-E1A57 - www.everettwa org I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED _ � <br /> 81TE ADDRESS t v 4�t C�, U� PARCEL TAI(I.D.M PERMIT N � ��, <br /> Ilr?t�- �Uot�. �a.� �4 . bS`1�O000�(,0000 � i <br /> I F�AL—'� LOT NO. BLOCK TRACT I <br /> orsc <br /> OWNER ADDRE88 CRY210 PHONE II <br /> , . r � c�«h �.�c„c N <br /> CZ �cacl� `� �^^pvc,�Cw��N � \U -�c� t�lacw �.4. �ii3�'=F ---- � <br /> TENANT NAME CONiACT FOR PERMIT PNONE �. <br /> M��t, +t��r�- t�- a„� �t,�„sor �tias� 3� � - Suy�� <br /> CONiRACiOR ADDRE89 CITV2IP PNONE �4a�) <br /> � �\�o N''i�v`,S�nc. y��pU H2vbo�•p P1ac� �v1��\<to <br /> C�N R.LICEN9E� s�`�L— .�-�p — --3�� ' �U�y �� <br /> u'1�1�_oH oD q� ��s <br /> USE Of BUILDINa HEAT SOURCE CONTRACT PRICE OF WORK , <br /> Q C�Vv��m 4-+�\'t� _,Eler,tric . Ges _ Other I � I-+I��) n' <br /> WORK DESCRIPTION � <br /> — - — MECHANlCAL <br /> PLUMBINa <br /> NO. TYPE OF FIt1URE OR iTEM NO. TYPE OF FlI(TURE OR ITEM i <br /> Ta11et __ _ A/C -eir hendling unils I <br /> Bethtub __ Forced eir syetems <br /> .._ La�atory(wesh beein) _ - Ges piping . <br /> Shower __ , Weter healai . <br /> �. Kitdien einM 8 dlapoaal _ Gas firaplece � <br /> DishNesher . Gas range <br /> Clo�hes wesher _. Clalhas dryer <br /> Leundry Vey Fange hood <br /> Sink (servicelbprlmop/etc) E■heust len <br /> Beckllow preventer ._ Heat pump � <br /> Unnal _ _ Uni1 heater ;'\ <br /> Boiler '� <br /> DnnMingFountain � Refngeration �!U,� '� <br /> Floor drein �� ' � � <br /> Greeea Irep __ W�dstove �, � <br /> = Rooldreine----- — Othnr_-. � ^rIIL � <br /> — O�her —_—_ _ —__— _ �r b i <br /> � <br /> � CITY OF EVF.RETT LOCAL SALES TAA CODE IB 7103 <br /> I hereby cerilily thet I heve iesd end exannned iMs applicalion and know the same ro be hue and conect. All proviebne of lews end <br /> ardineces goveming Ihis type ol work will be complied wilh whelher speci6ed herein or noL The grenting of a permll doee nol preeume <br /> to give eulhority to vlolale or cancel the provision of eny other slate or local law reguleling conetructlon or Iha pe�formence of <br /> conslmction That I em authonled by the owner of thia propeM to peAorm Ihe work Por which eOPlicafion le mede end I comply�Mith the <br /> Stete ContrectaB Lew iP27 RCW and 296 200 WAC. � <br /> �— �-IS -L'� � ) I <br /> Signelure ol OwnedCon�.re r Aufhorized genl ��P � <br />