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F�ERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEUAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM 3 —D 9—O� <br /> SITE F�DDRESS PARCEL TAY.I.D.A P RMIT p I / <br /> , � r/ � �- � . r r^��, �, c, � � 3 L� �' c c 3 �� r'�- � 7�,� '�1.� <br /> l o (4- //� J J '�--- � <br /> LEGAL LGTNO. � BLOCN TRACT <br /> ��— <br /> OWNEF2 �� ADDRI�S! CITY2IP PHONE <br /> a"-.•i!'� � / � <br /> _�-�Le� .�� 2�.�k ��, �- �; a r�L s �W ��.�-� �03 C� <br /> TENAN i NAME CONT[.CT FOR PERMIT PHONE <br /> -- ��n�'�'; s 'f� �4 a��, 7 aa - �y�� <br /> CONTRACTOR ADDRESS f,ITY21P PHONE <br /> l <br /> COIJTR.LICENSE p � <br /> �,i�(./I-yn� <br /> USE OF DUILDING HEA?SOURCE CONTRACT PRICE OF WORK <br /> �')- '�! N ' -- 1 _Eloctrir. __Gas_Olher <br /> ✓ <br /> WORK DESCRIPTION <br /> <� ����� ���i�. <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF fl%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilot A/C-air handling unlls <br /> Balhlub Forcad air systems <br /> Lavatory(wash bosin) _ Gas piping <br /> Showor Water hoa�er <br /> Kilchen sink &disposal _ Gas firnplaca <br /> Dishwashor Gas ranc�e <br /> Clothas wash�r Clothes dryer <br /> Walor hoalor Rango hood <br /> Sink(servico/bar/mop/olc.) _ Ezhaust fan <br /> BackOow provanlor _ Heat pump <br /> Urinal Unil hoator <br /> Drinkinp Fountain _ Doilor <br /> Floor draln Rclrigeratlon <br /> Groaso trap _ Woodslove <br />� Roof dralns Olher <br /> Othnr __ — _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I horoby wrilily Ihat I have read and examined this application end know tho same lo be lrue end wrrect. Atl provislons of lewa and <br /> ordinacos poverning this typo al work will be complind with whether spacified horaln or not.The granting ol a permit does nol presume <br /> to pivo aulhority to violat�or cancol!he provision of eny other slale or local law regulaUng construction or lhe pertormance of <br /> r,onslruction. Thal I am authorizod by lho ownor of this property lo peAnrm Ihe work lor whlch eppllcalion Is mede and I camply wfih the <br /> Slalr. Coniractors Law 78.27 RCW and 29G.2p0 WAC. <br /> �.� -�.. � �'✓" !; � -� F� - � �- <br /> Signa�OwnedCnntroctarlAulhonzed Agont Data <br /> �/Z <br /> I . . . - --- � ---- — — <br />