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� � <br /> PERMIT APPLICATION , <br /> CITY OF EVERCTT PERMIT SERVICES ��s�� 7-C%i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425257-8870—FAX425-257-8857—www.everetiwa.org `����,�'�"r�� "_ <br /> APPLICATIONS ARE ACGEPTED FROM 8 AM TO 4 PM -DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS uM{�� PARCEL TAX I.D.N PERMIT <br /> I�0 • +,�` s O(o 2 e � <br /> LEGAL LOT N0. BLOCK TRACT <br /> DESC I <br /> OWNER 1$Ilos�.LVP+SVC1.leNSRd ITY_/Lj ��g ONE �'`� ? <br /> L�,(�1G�� !��' J <br /> J- a �a, �!-o�NVi�lnc . *�zao 4iscz�o <br /> TEN�AME CONTACT FUN PERMIT i(PVII'I S ta,L la ePHONE <br /> � I �r'n ��l�Y�"i�7 �rc� y2533`���57 I <br /> CONTRACTOR�C_ �� i15 d-�OV� ADORE83 CITYlLP PHONE <br /> JQ %T r!CJ <br /> CONTR.LICENSE A�C1H C I��v`�(�� _ <br /> USE OF BUILOIN6 I HEAT SOURCE CONTRACT PRICE OF WORK <br /> SF� _Eloqric �Ges._Other <br /> WORK DESCRIPTION -_ ' � <br /> I , R,� ,�C�P)')�71, ��� c��� s c' <br /> �� <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> � Toilet l�/ _ A/C-air handling units <br /> Bathtub�� � Forced air systems <br /> �-6nvatory(wash basin) //ii - 'as piping iNl <br /> _�, Sho� / _L, ler heater <br /> ___i_ Kitch sink 8 disposal � sfireplace / <br /> ,� Dish asher � asrango <br /> � CI es washer Clothes dryer <br /> La ndry tray Range hood <br /> _ Si (service/badmo�letc.) � �xhausttan �;�� <br /> Bac flow prevenler H t pump <br /> Urina� Uni eater <br /> Drinkir�Fountain Boil <br /> Floor drain Refi eration <br /> Grease Irap Wood ve <br /> Rool drains Other <br /> Other <br /> CITY OF EVERETT LOCAI SAlEB TAX CODE 19 7106 <br /> I hereby ceritity fhat I have read and examined Ihis app�ication end know the same to be true and wrrect. NI provisions ol laws and <br /> ordinaces goveming this type o1 work will be complied wilh whether speci5ed herein or not. The yranting ol a pertnit dxs not presume <br /> to give authonty to violate or cancel the provieion of eny other state or local Iaw reflutating construdion or the perlormance of <br /> construd�on. Thal I am authorized by Uie owner of this property to peAoim ihe work for which application is made end I comply with the <br /> S�taQte Contr or w .Y7 W and 296200 WAC. <br /> (/ �M� /� -�/, �o� <br /> n ure o ontrecbr/ ut iorized gA enl T-T al)� ���) � <br /> S` /��/" G/ � <br />