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rERMIT APPLICAT�ON
<br />CITY OF EVERETT PERMIT SERVICES �_ 26 -o�
<br />3200 CEDAR STREET. EVERETT. N:A ��9201
<br />��5-257-8810 - FAh 425-25i-8857 - �a�v�v.everettwa org , t t �' � �� �- � .)
<br />APPLICATIONS ARE ACCEPTED FROM 9 AM TO 4 PM � �, � UC �
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<br />'+rtf �DDRE55 ����� � '�, � . ' PARCEL TA%1 D. d I P MIT tt ,
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<br />� LOTNO � BLOCN I THACi
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<br />C—t�pd.GJi%�KW A�DRE55 CITriZIP PHONE
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<br />1f 1�ANT NAME CONiACi FOR FERMIT PNONE
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<br />CONiRACTOR �� �� �� —���� ADDRFSS—�— t ���--����— GTYQIP
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<br />USf. OF f3UILDING I HEAT SOURCE
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<br />�yr7RK DESCRIPTION. . . . . � . .-----�---��--
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<br />PLUME3ING
<br />TYPE O� PIEIURC OR ITfld
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<br />i .�..dory- ptash I�nsinl
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<br />� n��n siN. 8 disposal
<br />' ".:ushtvr
<br />� ri��s washOr
<br />.. . .., hcater
<br />�� iscrvicebar,mop�etcJ
<br />_ � hu�.v preventer
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<br />, �i��n�.ei� Fountain
<br />� h�or drain
<br />�3re2so �rap
<br />Ruol tlrains
<br />Other
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<br />PHONE —�—�.. . . . � � . .
<br />�(il5 '74?�-lll$
<br />CONTRACT PRICE OF 1YORK
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<br />3oJlk-C��tt � 3 to
<br />MECHANICAL
<br />4�i TYPE OF FIXIURE OR ITEM
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<br />_. _ __ ; �--aifhan-.1h�i�,iw�d�
<br />. 7 I �-�,rced eu ti. �.!. , .
<br />� I ; �,as pipiny
<br />.. � ,'. wer he,�h
<br />i � . : ;.is Ive�,L� . �
<br />, � � �_�,is rany��
<br />�'. 1 I i:;r�lhes dr.�.�
<br />, � �I Rangehor.�: /P1��Rro
<br />, 5 I l-,h:ausl lan
<br />. . � I���at pump
<br />, Und he�lor
<br />9odor
<br />lielnyeralion
<br />W oodslave
<br />Other
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<br />CITY OF EYERETT LOCAL SALES TAX COOE IS 7105
<br />- . cerddy that I have read and eRam�nr,� thrs appUeahon and know the samu to Ue true and wrrecl All proviswns of lans :r �
<br />�. ��s qo:eming th�s t�pe ol work will be complicd wilh whethar specdied hercin or nol ihe granhn9 0( a permit tloes nol prc�„��.�.
<br />-�.vlPont� 6. �.���;�I�� or �-ancel the provlsiun n� any other s1a�e nr lor.al la�.a inr�ulabnq ronslrucli0n or ihe perf ��rn�n�.�F ol
<br />. . 1 P.� . �.d'� n: �,d h.� Ihr owner ol ihls propehy to perforn, Ihr :.� �. i , r. , �i���� I ... . � �� r�.i :�� .r�. t , .. . •
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