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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR 3TREET, [VERETT, WA 98201 <br />425�25i-8i110 - FAX d'25-257-8857 - www.everet�wa org <br />;'� _ ��' — APPLICATIONS ARE ACCEPTED FROM 8 AM TU 4 PM // 7�z "2d <br />�a <br />SITE AUDRESS � ,�GC.� <br />2II20 - 112'�' ST. $1p. <br />I i f.ld �, LOT NO. BLOCK <br />ui s� • <br />�----- - <br />OWN[R <br />MAFL� WO6o CouR`i' L(,C <br />7ENANiNAME <br />-`(.ONTISA�Tbfi <br />CONTH. LICENSE n <br />PARCEL TAX I.D. # PERMIT p <br />--10053790000450� +ooS379�4Goa��.L'_��_ <br />7RACT Oq SUBDIVISION M <br />TRACTS �45t4(o RAT oF PA�nIH F�t�-O ADp * Q_ _ <br />la6o'7- TIHRD Gi2.5•E. <br />CONTACT FOR PERMIT <br />USE OF BUILDING <br />StNGi� FM�u.Y TcwNNou5e5 1--- <br />WORK DESCRIPTION <br />HEATSOURCE <br />NILL CkEEtC, <br />wA. 98oi2 <br />PHONE <br />%� f.leChir _ G;�s Oihci <br />I�!Jc9� <br />� ? <br />CC�NSZIiUCT A SINLLE FA�ill..�-( Tow�vµGuS� — U�� 7 / J <br />- PLUMBING ---- --- -- -- <br />NO. TVPE OF FI%TURE OR ITEM <br />� loilCi <br />Q Oallllub <br />3 . l.lVi71UlY �Wt1511 O85i11) <br />Showcr <br />1 Nitchen s�nh 8 disposnl <br />I Uishwasher <br />� Gnthes washcr <br />I Water healer <br />Sink �sorwtoibanmop'cla ) <br />�achllow preventcr <br />Unnal <br />Drmhutg founlain <br />Roor dr,un <br />Grease t�np <br />Ro��f diains <br />Othei <br />1�25 • 359 - �2 8(0 <br />CONTRACT PRICE OF WORK <br />��i 3, ° 3 � • � -- �I <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR IiEM <br />I <br />hC - air handling un�ls <br />� OfLCd All Sy51C1115 <br />Gas piping <br />Water heate� <br />Gas lireplace <br />Gas range <br />Clothes dryer <br />Hange hood <br />Esliausl lan <br />Ilcal pump <br />Unit hoator <br />�oticr <br />Reingcrntion <br />Woodslove <br />CITY OF EVEPEIT LOCAL SALES TA% CODE IS J105 <br />I i�ciehy cerilify �h21 I h�ve read �nd examineA Ih�; apphr.auon nnd Fnow the same l0 6c truc and correct. All proviswns o� laws and <br />��idinaces goveuuni� Ihis lypc o� wo�k will 6c r,omphed �•.ith whcther speci6ed herein or not. 7he granting ot a pernnt does not presume <br />!„ y�ve auihonly lo violate or cancel the provismn ol any olher slale or local law regida�inc� cons�ruclion or Ihe perloimanca ol <br />� onslruction. That 1 ain �uthoYaed by Iho owner ol Ihis propeity lo pedonn Ihe woik lor which application is made and I comply wnh thr, <br />��iaic Colltiacto�s Law �827 RCW and 296.2on wnc. <br />//-D <br />�(Z <br />