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F'ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AD�RESS � . /, PARCEL TAX I.D.p PERMIT p <br /> r /�'' ^' .� �' -1 U1C; Oil� <br /> � <br /> LEGAI LOT NO. ALPCK TRACT OR SUDOIVISION N <br /> n�sc _ _ <br /> OWNER AUDRESS CITYlZIi' PMONE�y� ��,3 �_ <br /> y� � <br /> � � , ) / <� r � <br /> _�_� I C �clf.�l �..v __ �� �C'!' f3' V C ��i � Ci� �Y11 ���i�i <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I E�hIAIL <br /> i -�au�A�-rarr----- �-- <br /> ' CONTR.L�CENSE N <br /> USE OF BUIlDIN3 HEAT SOURCE CONTRACT PRICE OF WORK <br /> — - — _- -- � _Elodric __Gas ._Oti;o�_ <br /> WORK DESCRIPTION <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTIIRE OR ITEM NO. TYPE OF FIXTURE OR IiEM <br /> iuilal � _ A/C-air handlinc�unils <br /> ��-- - ���������� Forced air sysloms <br /> Lavolory(wash basm) _ Gas piping <br /> --- - Shower Water hoator <br /> � hilr.hen sink 8 dis{x�s;d ,__ Gas lireplace <br /> Uishwasli�r _ Gas rango <br /> � ClnUies washer __ Clolhas Aryer <br /> Wnter hflater __ Ranc�a hood <br /> I __- Sink�sorvir.e/bar/moplclr,.) � Ezhaustfan <br /> [3ar.kllow prevenler Hoal pump <br /> � Unnal __ Unil hoalor <br /> Drinkin� Founlain __ Boiler <br /> Fluor drnin Rofrigeralio� <br /> Gmese Irap __ Woods�ove <br /> Rool dr iins O�her_ <br /> --- -� Othar <br /> I CITY OP EVERE7T LOCAL SA�ES tA7(CODE IS 7105 <br /> � I heroby cnritily thal I have rr,ad and exnmined this appDcalion anA know tno same to be Iruo and correct. All provisions of laws and <br /> ordin�crrs�ovnrnin�this type ol work will bo complied wilh :�hMher spacilied horain or noL Tho granting of a permit does not presume <br /> � lo�ive aulhordy�i vlolale or cancel iho provision of any other slale or local law regulating construction or tho peAormance ol <br /> I r,�rsiruclion Thal I am aulhorimd by tl',e ownor ol this proporty lo perfnnn tho work lor which application is made and I wmply wi�h Ihe <br /> IState C�ntradors Lav: 70.27 RCW and 296200 WAC. <br /> I _ . __.'__. ". <br /> 5iynature o�OwnedCoNractorlAu�honmd A9ent � Dato <br /> i _ _ <br /> . _.. --- --- - _ _ .._ <br /> - ----- <br />