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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-2b7-8810 - F/U( A2&267-8857 - www.evereHwa.o�p <br />APPLICA7MN8 ARE ACCEPTED FROM ! AM TO � PM C{ „ <br />StTE ADDRESS <br />2,12�I — l 12.'�ST <br />LEpA �OT N0. <br />DEBC. �fjl�E �/i(!� Z Q <br />PARCEL T/Uf LD. � <br />oos3��v000 <br />BLOCN TRACT OR 6UBDM810N, � <br />>O D 2 � <br />�Eco �aoPr,�-n�s izy��.����.r� <br />��� �� CONTACT FOR PERMIT <br />� Ur%�K E���/C L�D ii✓G I,r}/1 ul E 7� E7�r <br />coKrx. uc�ae � <br />USE OF BUILDINO <br />Co�nK�ti�c OfFicc� <br />HFAT SOURCE <br />_ eioa�c .! oas _ oa�ar <br />WORK DESCRIPTION x/�, N ��r v G�`f�� L� <br />�E.�,, o � s <br />�(fC1'x�C�9G CO�7'7CR�?"1Ny <br />Ip. I TYPE OF FlXTURE OR fTE111 <br />Toilel <br />Bethtub <br />Levelory (wash beeln) <br />Shower <br />KHdbn eink 6 daposd <br />Dkhwaehx <br />Clotlies wesher <br />Wetar Meter <br />Slnk (servloelher/moNe1F) <br />BecJclbw pravenlx <br />Utlnel <br />prlMckg Fw�ntain <br />Floor dreln <br />Oreese Irap <br />Rool drdns <br />Ott�or <br />NO. <br />1/ I V� -�0 <br />VZS•lv7-7�o� <br />�^�IW°�� <br />fONE }/�J"'? CI �f `S <br />D'ucc <br />�un. d�ftrnv�r�c,u. <br />CONTRACT PRICE OF WORK <br />�e.L I«��L` <br />ot�ic.�- <br />MECHANICAL <br />TrrE oF rvcr�� aa rteM <br />A/C - ek handNrq u�Yts <br />Faced ek aysteme <br />(ia� pqlnp <br />Water heaMr <br />c3ee fl�eplece <br />Gas renge <br />CIaU� diyer <br />Ranpe Mood <br />Ezt�ausl fsn <br />Flee� P�P <br />Unll hbeter <br />Bdbr <br />Reh�pe�atlon <br />Waodstova <br />Otl�er <br />qry pF EVERETT LOG1L 6ALED TA% CODE 1! f/06 <br />� he�eby oerliy IAat I fieve reed snd e:smined MN apMic�tlon end know tln wne b be trus �rd corrxt M prwhbrK d Mw� and <br />adUwbes Ym'emki9 �s ype d work wIN be campNed wHh wlro�h°� � hereln a nd The prwAkq d� ps�rtdl dw� nd prewme <br />k 9Na euthaMy lo Walele a cancel Ihe povklan d erry other �Me or ba tl�e wark (or wMd� �ppM�tlon«N r�db nd aornply wXh the <br />corotruGbn. Thet I em eWwAzed bY the wn°r ol lhfs pmpxty lo pxfam <br />Stete Cg�M"reclors I.yR+B.27 FCW and 280.200 WAC. �2///O <br />/.bC/ � <br />