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PERMIT APPLICATION <br />(;ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE[T, EVER[TT, WA 98201 <br />425-257-NF110 - FAX 425-257-8857 - www.everetiwa erg <br />���'�__ _— APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �.� % � 2- /� <br />SITE ADDRESS <br />2A 20z I 12'� ST. 5. E. <br />i t���nl LOT NO. BLOCK <br />�, ,:, � - -- ------ - <br />OWNER <br />MAPL.F WOo� Co�R7 L�C <br />FARCFL TAX I.O. # PERMIT N <br />005379�004501 +005379�'ir.00 (' �/�%-/�� _ <br />TRACT OH SUBDIVISION p <br />TRNCI'S 45+4�o PIAT OF PA��1H F�ELD k0� k Q__ <br />IA6o7- T1+tQD q2. s.e. W 980�' 425-357• a28�o <br />TENAN�NAME CONTACTFORPERMIT PMONE <br />E•MAIL <br />��NTRA�Tb �66FE3 � I �--... I <br />CONTR. LICENSE p <br />USE OF BUILDING I HEAT SOURCE <br />s�NGI.�_FAMILY TOwNN0�SE5_I _ X �i_�i���: u:i�_�ii�c� <br />l <br />WOF;K DESCRIPTION <br />I <br />CONTRACT PRICE OF WORH . <br />a_ <br />�/0.� a7°-- ------- <br />CGlySiRVG'T' A SINGLE FA�ill.�{ TGwNNOUSE —(UNI ��� <br />� <br />PLUMBING MECHANICAL <br />NO. iVPE OF FI%TUR[ OR ITEM N0. I TVPE OF FI%TURE OR ITEM <br />_ . . _ ____. . _ . . .. _. _._ <br />� Io�le� <br />'� Gdlhlub <br />�j Lrt dNry �wasl� ba9n� <br />',howm <br />� wdrhen sinh 8 dispusnl <br />� I�ilh14JSI1Cf <br />� Cinlhes washei <br />W��ic� hcater <br />ti�nh (sorvice�barlino�relr.,) <br />Bcickllow prevenlm <br />Uimal <br />Unnhing founlaln <br />floo� drain <br />IGrr.aseliap <br />� Rool diams <br />Othei _. . . . _ _ . _— � <br />I P.0 � .lu `�ntllmg unds <br />_ � foiced nu ,y5icm5 <br />__ Ga5 pipirg <br />Walc� healor <br />Gas hmplace <br />Gns renye <br />I� C�olhcsdrycr <br />_f Ranye hood <br />�- [xhausllan <br />Hcat pump <br />. _ Unit haater <br />Botlei <br />_ qelri�eration <br />__ Woodslove <br />Olher <br />CIiY OF EVERETT LOCAL SALES TA% CODE IS J105 <br />����by cerddy thal I have read �nd exanuned Ihis applicalion and tinow Ihe same lo be tr;._ and carecl. All p�ovisions ol laws antl <br />�����.,ces 9overnu�y tlus lype ol woih will be comPlied with whether specilied hmein or nul. The granting ol a pemn� does nol pieswne <br />� r�. e�ulhoiily lo violale or r.ancel Ihe provision ol any �Iher slate or local law regulaling conslruclion or Ihe pe�lurmance of <br />��.nuction. That I nm �ulhonzed by Ihe owner ol Ihis propeAy lo pedorm the work lor which applica�ion is made and I comply w�th the <br />�•.�•� � �C(onlr�clors La�.v Id.27 RCW anA 296 200 WAC. <br />��,/,,,_fc�i„� C � � /O - //- O % <br />;�, iiwe uf Ownen onlraclorA unzed �r em Dale <br />�Z <br />