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PERMIT �\PP! "'ATION <br />CI'TY UF EVERETT PERIVIIT SERVICES <br />i 3200 CE� 1R STREGT, EVERETT. WA 98201 <br />' 425-257-8810 AX 425-257-a857 - www everettwa org <br />_'� "��7 J �� �V APPLICATIONS ARE ACCEPTED Fh �M 8 AM TO 4 PM j_ �. {_J <br />ISITE ADDRESS PARCEL TAI( I.D. p PERMIT p <br />�` <br />I FRea..�A• � �0.ce��-�+�1�'�e Q4�3g-000:�9 3-00 07,z'-Q�1_(.._ �/� %� <br />I II.G�M LOT�I BLOCK TRACT <br />i��� ;`-l�a• �� 1 ca�_D-� s�����rc. �.s 3- - <br />N O � ft� � D�'v'�-aPrriv �ri'sec. <br />TF.NANTNAME <br />N�A' <br />C(7NTFACiOR �O BE AE�72�7-M�Nt'.{� <br />CONTR. LICENSE � <br />USE OF BUILDING S�u9I�� �yryh� (,� <br />ReSic{e�-1�i0.1 C[ouoo�.;�;w,� <br />'NORK DESCRIPTION <br />'lD CbN•S'f2u�-� S S�NroLC <br />NO. <br />PLUMBING <br />TYPE OF fIXTURf OR IT[M <br />�_ 1nAe� <br />_ (_ Oathtub <br />_4_ La•�alory (wash basin) <br />j_ Shower <br />J_ NAchen smk E disposal <br />../_ D�sl�washer <br />j_ Clothes washer <br />f_ t.aundry�ray <br />.(_ Sink Iservicelba•'mapletc 1 <br />Dackllow prr.venter <br />Unnal <br />Dnnkmy Fountam <br />Floor d�ain <br />� Gmace I�ap <br />i}_ Rool drains <br />Other <br />ADOPFSS CITY/ZIP PHONE �/2'$'asl-61O <br />�p��s �allo avE s �� w►, ��o3Z <br />CONTAC7FORPER+y,T � PHONt <br />W q� ue W+�,� y2.�- (�Sb- 7Y35 <br />AD�RESS <br />CITY2IP PHONE <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />� [$�' <br />—Glerlric VC3,�s _ _.Olhrr _ _—_ ,�'/���' (�j— <br />�Am��y .DP'i�4��A CONDOM� Niyn1 I.IAIiT <br />-- -- � �—�-- ------- — <br />-1 MECHANICAL <br />INO. I TVPE OF FIXTURE OR IiEM <br />A/C - au handl�ng unils <br />Forced air syslems <br />_�_ Gas piping <br />__�__ Water heater <br />._f_ Gasfireplace <br />Gas rangr. <br />Clothes dryer <br />Range hood <br />�/ _ f_�hausl lan <br />_ Healpump <br />Umt hcaler <br />f3oder <br />J__ Reingera6on <br />Woodstove <br />i —I— ---�----- I —� — <br />' CITV JF EVERETT l UCAL SALES TA% CODE IS ]705 <br />� I hereby cenlity that 1 have read nnd exammetl Ihis applicahon ind know the same to Ge true and conecl All prov�sions ol laws and <br />� niJmaces govennng Ihis lype ol woik v-nll be cemphed vnth wfwzther speafied hei� in or nol The granU ig of a permd does nol presume <br />t�� y�ve autnonly to wnlale or cancel Ih� pmvision of any olher stale or loca� law regulating co�struclio�i or Ihe perfortnance ol <br />', . nnslru n That 1 am authonzed by Ihe ownei ol lhis property fo peAorr�. Ihe worh lor which appGcalwn is made and I comply vnth Ihe <br />�� 'li,�le fir clors La 1B 27 RCW and 29B 0 C <br />I � ''G � 1,(� � �"�'� Il"Zl'OS <br />�I '�i atwe o�wner/(.onN cloriAutho [e Agent �� Date <br />�� 7 <br />