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SITE ADDRESS <br />��� � 4� P� sC <br />IEGAL L�, <br />OESC. � � <br />P��tNll�' APPLICATION <br />CITY OF EVERETT PERM{'T SERVICES <br />3200 CEDAR STREET, EVERE:TT, WA 982U1 <br />425-257-8810 – FAX 425-257-8r,57 – ww��.everetc• ,.e�g <br />APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br />l�'G -1 < �,� �' / � <br />PARCEL T.>% I D. # ,�PERMIT p � <br />2�, a�i"Tc,�,-'.�`f�uo �;��-�.� �� <br />- - -- ---� — <br />TRACT <br />=)�,-oOZ' "S <br />OWNER ADDRESS Gm¢IP Pnone �} c� — <br />J(Co�S��'� -1it;Y���S ���G',�, 31r''�i`>�� �nID�� `�isZ��C, >>3� �����1`i - <br />TENANT NAME � CONTACT FOR PFRMIT PHONE <br />. I . ' •' . <br />� 1 � - -' ---- - � - . <br />, . � . __ <br />CONTRACT9R ADDRE53 CITY2IP PHONE �� Z�" <br />J('C'�)�r�i !-�jtmf'� ' <br />. . , 1•.• <br />CONTR.LICENSEp �. . •' <br />�i1101��1i7CJ��r�Mt-----II l0 � ri. � •jhn+.l �!`�i��o �>�G c��IV� <br />�3, � ) _�.1 `� _ — <br />USE OF BUILDING I HEA7 SOUR�:E CONTRACT PRICE OF WORK <br />�-�-1,� I _El��clric _Gas _--Othrr — --- <br />WOF.K DESCRIPTION <br />/' <br />��� rX,�,� -7 _ <br />��- <br />�---- --- <br />PLUM BlNi3 MECHANICP'. <br />NO. ?YPE OF FI%T��RE OR ITEM NO. TYPI= OF FI%TURE OR ITEM <br />�_ Toilot A/C - e r handlin{) units <br />2 Balhluh � Fo�ced air systoms <br />� Lavatory Iwash basin) P ns pip ng <br />/ Showor 1M1'aterh�aler <br />� Kilchen sink R disposal <br />�_ Dishwashor <br />Ci�!hes wash�r <br />_�_ Walr,r healer <br />Sink (sr,rvice�barhnoplelc.) <br />Backflow prevontm <br />Urinal <br />Drinkinp 6c .�ntain <br />Floor d� i�n <br />Grease anu <br />Root drdn;; <br />Olhur <br />= G.as fireplaco <br />_L f,as rani�e <br />�_ <;lolhes.fryer <br />�Rangeh�od <br />Exhaust fan <br />_ Heal p.iv p <br />�nit heaNr <br />---' B � lor <br />_ ke'riser�fion <br />, Woc.dslove <br />-- - Ulhor <br />CITY OF EVERETT IACAL SAI_ES TAX C ODE IS 3105 <br />I hr.reby ce�itily Ih�l I have mad and examineA lhis applicalion and know Ihe s2me to ho irue and currect. All provisions ol laws anA <br />urAinaces governing Ihis type ol work will 6e complied with whether sp�cifiod here�n or nol The granting ol a permil does not presume <br />lo give aulhorily lo violate or sancr.l ihe provislon of any olhei state or local law regulalinq cons�ruclion or the pedormance of <br />constniction. That I am aulhorized by ihe cwner of lhie properly lo pedorm Ihe work for whlch application is made and 1 comply with Ihe <br />Stala C�nUaclors Law1H.21 RC�V a�d 2�3fi.200 WAC <br />a-��-��� _�� � <br />Date � <br />Z <br />