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SITE ADDRESS <br />UFSC <br />PEkMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATI�NS ARE ACCFPTED FROM 8 AM TO 4 PM <br />��� tl��� J�cJ <br />BLOCK <br />PARCEL TAX I.D. A <br />�,c', � �' y�'CY�i� <br />TRPCT OR SUBDIVISION N <br />OU P�/L�� �� <br />-_._--__.—�— <br />OWNER AODRESS CITV/ZIP PNONE <br />Fa <br />�( �"_r, —�u �J ��_ I 8 Zv 9�" � S c� ��c,c.rcc.1� �i�•�c�Y <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />-�-o-,�-n� Jra � _ ���v,� i3, n� <br />CONTR. LICENSE N <br />----�- r.. f��.1 �'� C` I 1 i <br />USE OF BUILDING <br />WORK OESCRIPTION' V 1 � I✓, �-` <br />- — — --- PLUMt�iiJG -- <br />NO. TVPE GF f�ATURE OR ITEM <br />Tuila� <br />--�— �alhlJb <br />_ Lavatory (wash b��sin) <br />Showcr <br />Kilchen sink & ditipus; <br />Dishwashur <br />Clolhes washr.r <br />-- �- W�ler heata <br />Sink (servicolbai!mu�r�olc � <br />-- F3achlluw proventm <br />Urin:+l <br />Urinkinr� Fauntain <br />Floor dr.�in <br />-- Greaselrap <br />Rool drains <br />Other <br />_ /03 ��¢ ��{�.�� �iur rnxnc� � �% %00� <br />710 <br />� �� �.,�ys �, �r� , �.�- �����, <br />fIEAT SOURCE �QNTRACT PRICE OF WORK <br />j{ c� <br />EIer,Irir. ___ Ga.s ___ Other /�_`� � <br />��,1'� � � f� �- <br />� ,U C �,, wc-� � u` �-i�c. l <br />c'��.�� -F�✓�� ���c�c� <br />N0. I TYPE OF FIXTURE OR ITEM <br />_ _ A/C - air handlinc7 unils <br />_ Forced aii syslams <br />Gas piping <br />Waler hea��f <br />_ Gas fireplar.e <br />_ GasranyA <br />Clothns dryor <br />_ Ran�n hood <br />Fxliausl fan <br />_ Heal pump <br />Uni! healer <br />Boilar <br />Relrigoralion <br />P�oodslove <br />Olher <br />CITY OF EVERETf IOCAI. SALES ii'J( CODE IS 7105 <br />I hereby cerllity thal l have rcad and examhicd Ihis applir,alion and know lhe same lo be true end correcl. All provisions ol laws and <br />ordinar.es governin{7 �his lypr. of wurk will be r.amplieA wilh whother spocilied herein or not. The granting of a permil does not presume <br />lo qive au�hority lo violnlo cr cancul Ihe provision of any olher slalo or locai law regulaling conslruc�ion or Ihe performance ol <br />c��nstruclion. Thal I am authorirod by ihe owner of Ihis propc:Ay to peAon,. lhe work lor which applicalion is made and 1 comply wilh ihe <br />Slatr. ConlreckSrs Law 1y.2I�RCW and 2JG.2UU WAC <br />� <br />_e°!-t� _ � �+ % "��' <br />