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PERMIT APPLIC�TION <br />CITY OF EVERETT PERPAIT SERVICES <br />3200 CEDAR ;;TR6ET. EVFRFTT, WA 98201 <br />a25 257 8810 - FAX 42`i 257 8857 - www everetlwa orr� <br />_ �_� �� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��- i <br />--! /2'.� <br />SITE AOOHESS � �'� PARCEL TA7C I.D. p PERMIT p <br />2�2t3- I12"' ST. �'. - - 005379obo045o1 +005379� �C %/(,�'=v � �I <br />--- — <br />--- <br />I�lnl LOTNO. BLOCN TRACTORSUBDIVISIONp I <br />I°'" !' l TRACTS 45�4(o PLNT oF PA�KE r161.0 AOD x Q <br />� __ -- -- ---- <br />OWNER �- ADDRESS C11V-ZIP PHbNE - I <br />MqPL.�W06D COvR7 LLC IQ6o7-THlQDG12.S.E. W 98���' 1�25•357-028!o I� <br />T[NANTNAME � CONTACTFORPERMIT PHONE i <br />E-MAIL I <br />-CONTRA�S'bA ---------------A66-fi€�� --�iTPiltr—�FbR� -- �� <br />CONTR. LICENSE a �� <br />_-__..___—_—_____.___._.._____._.--___.___— __ ____ I <br />USE OF BUILOING HEAT SOURCE CONTRACT PRICE OF WORK �� <br />$INGLE �Ainu.Y TcwNNou5E5 X Clec�nc G��s O�hci � <br />---------- — - --- — - °= 3- <br />� 03� ------ I <br />WORK DESCRIPTION '� <br />CGl�57RUC7 A SINLLE FAn�IU-( TGwivNOuS��UN�T ��6 i <br />N0. <br />� <br />2 <br />3 <br />PLUMBING <br />-- <br />TVVE OF FIXTURE OR ITEM <br />lotlei <br />❑au,n�u <br />l.nvaloiy �wash bn5in) <br />Showc� <br />hilchen sink 8 d•sposal <br />Uishwashc• <br />Clolhes washcr <br />Walcn c�ater <br />Sink �servlce�baumop�e�a) <br />B�Chlluw p�evc��lm <br />Urinal <br />Urinhin� founlam <br />Floor dmin <br />Greasc h�ip <br />Fi001 �I:I.IIS <br />�I�ICf . _ . _ . <br />NO. �— TYPE OF FIRTURE OR Il"EM <br />I _ <br />I <br />I <br />'{- <br />A C- air handling unds <br />fbiced au systcins <br />Ga5 piping <br />Waten c�atoi <br />� ;as hreplace <br />Gas iant�c <br />Clolhes diyer <br />Hange hood <br />Gxhausl lan <br />i+cai pump <br />iLnt heater <br />[ioder <br />Hehigmnlion <br />WOOAS�OVC <br />�111Cf._-- _. '. __ __—_' <br />CITY OF EVERETT LOCAL SALES TA7f CODE IS 3105 <br />i <br />I iiereby ceritity �hat I have read and examinod �his applicnlion and know �he same lo be true and correc�. All provisions of laws and <br />� ��Jinnces gnvernui� this type ol work will be comphed wnh whelhcr specilied herein or nol. The c�ranting ol a pennit doos nol presumo <br />!�, ,�ive authonty to violate or cancel Ihe provisiun of any olher slalc+ or local law mgul�6ng conslructinr, or the perlorm�nce ol <br />�. onslrur��on. Thal I ain 2uthorited by Ihe uwnai ol Ihis pmperty to pedorm Ihe woiti foi which apphcation is madc anA I comply wqh Ihe <br />'�i.{�e � o���raclors Law 1827}iCW and 296.200 WAC. <br />; �.� ( % �,� �o ��. � -� <br />',�yn;t�urc ol Ownci � nli.m;ui �A� unlcd Aacnl D,ile <br />t /Z <br />