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Flpr .^_7 07 11 : 41a �rca 2066�21117 0, �0 <br /> � PERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR S7REGT, EVERETT, WA 98201 <br /> 425-257-8810- fAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM y�a � .O7 <br /> I — — <br /> SITE ADURESS PARCEL TAJ(I.D.N PERMIT It <br /> 21 � o I l� i�i �ng�1" �t= s�-�I'� i � 1�c%��v� - r`�r -7 <br /> LEGA LOTNO. BLOCK TRACTOp5U0DIVISIONN I <br /> I)Ftic;. $EE AZTK-�IED —_—�-4 <br /> OWNEN ADDNESS CITV� I ONE <br /> ' 5�1..VE� LAY.E C.�NTfZ l.�C SEA'tC� 20�. 1�22.06�g <br /> q� M,.�.�o.� ��- ��,Qa <br /> i TENANiNAME CONTACTFORPEPMR PHONE � <br /> �y��yE Jo[ (aQ.AZ1At�l0 2oco. E38. ��'o <br /> CONTRACTOR AUURESS CIry21P PMONF <br /> J.o. �lEv.h-oa coNs7, 1, <br /> CONTR.UCEN9EM � �ML�j Z�c.. �Z3. (p��`I <br /> I,CJ. gOX F�DO� � <br /> sflNc�rcz�a��c q8o z� <br /> i <br /> USE OF AUILDING HEAT SOURCE CONTRACT PRICE OF WOqK i <br /> _ v,�cA�T _ ✓��«�,��_�,5 __o��,P� l_ <br /> __ _ � <br /> WORK DESCAIPTION � <br /> l=�EM�L�T101J � " �� <br /> l. /� �� . � ' -� �,� J -�� � <br /> � PLUMBING MECHANICAL <br /> NO. IYPF. JF FIXTUHL OR ITEM NO. TYPE OF FIXTUqE OF 11EM <br /> 1 o�let � � A�C-�tr handlmg unqs I <br /> Bulhtub I�prCed an Systems <br /> � _ Lavalory�wash Aaslnl _ Gos piping <br />� __ Shower Water hnater <br /> I _= Kilchen vnk 8 disposal - Gas hreplace ' <br /> Uishwashpr Gas ranqC <br /> CfoUies washe� Clolhes drycr <br /> __ Walerhoaler Rnnpehoud <br /> � � Sink (servicclbar�n�op.�cic ) _� Ezhausl lan <br /> Backllow prevent��r Heat pump <br /> Urina� U�ut healc� <br /> Unnhinq Fountain BoilCf <br /> � .._ Iloordrain Hchigerauon I <br /> ' __ Grease trap Woods�ove <br /> . ._ Fnal d��ins -- � Olher <br /> Olhnr "_- ___- . <br /> I - _'"'_ -_ - _. ' _ <br /> __ _—. -_-__ I __ ____"' .--' .- I <br /> ICITY OF F.VFRETT LUCAL SALES TA%CODE IS JfO� I <br /> I nmeby cenldy Iha1 I h;�ve�ead and e�amined Ihis aGp�la�l�on anA know ihe same tn be�n"�;,nd r.nrrect. A� prm.isions ol liws and <br /> ordinpCes govurninq IhiS iype ol woik wdl be comp!ieJ will�wnelher specdied he�em m not. fhg granlutg 01 a p2rmrt tloes no�p�e9ume <br /> to�rvo aulho��ty lo v�>ia!e or COnCeI Ihe provision vl qny olher sla'e or�ocnl I�w�eguiahnq �unstrucbon or P�e perlormance o: ' <br /> I Con,UuGbon 1 h;d I a�n authorized 6y U�e ownar nl ILi, Uii,prrty to perlorm Ihe wuik�or�vh�ch appl�[at�on is made antl I cornply with !h� I, <br /> State Contrar.tors �_s+v 18.27 HCW and 796 200 IV�C. <br /> L—�•_,�—L� � �-. 2 C� �O�- . <br /> SipnnW�r oi Orhm� rac or utl�nived r9en1 Uate I <br /> ' ��ILvt=rz,. t_ A�.E c �rit�F= �--�-t� . I <br />