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P_..RMIT APPLICATI(.�J <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 CEDAR STREET, EVERETT, WA 98201 <br />a25-257 8810 - FAX 425-25; -8857 - www.everetlwa.org <br />APPLICATIONS AkE ACCEPTED fROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS �� � PARCEL TAX I.D. p <br />IC� � ��---�- �) S L� OC7 S� -C�QB. �c <br />LFi;AL LOTNO. ' 9LOCK TRACT <br />� <br />nt s.: �c �-'{w., of 4 �— < ; , .. � � � , � . <br />1 - --- <br />OWNER AODRF_SS <br />PERMIT fl <br />- d � Coso6 -03 <br />ii <br />PHONE <br />L�' a1 �� /�(�',�i�•d ?n�__�O �_ c t 7/�(i �, yt���Z.S z'�6% <br />TENANTNAME CONT4CTfOR PERMIT PHONE <br />CONTRACTOR <br />�- )�! � i q, � f`i / f�,,,;•�: � Tf � L <br />CC`ITR. LICENSE p . <br />i �/r / 7 J �i' T <br />USE O�DING � <br />� ��L <br />WORK DESCRIPTION <br />II NO. <br />S"% /< <br />PLUMBING <br />ADDRESS <br />J 4 I�-Q <br />HEATSOURCE <br />CITY/ZIP PHONE <br />CONTRACT PRIC: UF WORK <br />I_ [Icctric� Gas--O'hcr I �sL C= `—'---- <br />-- ------ � � <br />-1` � 5 `--1� /� 7 MECHANICAL <br />TVPE OF FIXIURE OR ITFM <br />TnJr9 <br />��_ 13,rthtul� <br />j._ L��4al�,ry (wash basinl <br />Shuwcr <br />/ Kitr.hen sin6 8 disµ�sal <br />i Dishwashor <br />/ Clolhes washer <br />/ L.wndry tray <br />_ Sink �+crvicelbadmopletc.) <br />Bar.kllnw prevenlor <br />Urinal <br />'ri�ikii+� Fuuntain <br />- - rli��xdrain <br />Gruase tr. p <br />Roul drains <br />Othar <br />NO. <br />_� <br />TYPE OF f�XTURE OR ITEM <br />NC - air h;mdllnp units <br />Forced air systems <br />Gas pipin,y <br />Walur healer <br />CBS IIfC�)IeCE! <br />Gas ranyc <br />Clolhas dryer <br />Rangr.hood <br />Exh:wst fan <br />Heal p.imp <br />Unit heatur <br />�oiler <br />Rafrigeration <br />Woodslovc <br />Olher <br />CITY OF EVERETT LOCAL SAL[S TA% CODE IS ]105 <br />I hereby cen!dy Ihal I have read and e�antined Ihis applicnlion anA know ihe same lu be Irue and corre;cL All provisions of laws and <br />� �rdinacas g�rverniny Ihis type of work will bo complieA wilh whelher spocilicd herein or nol �hn �ranling ot a permit does not presume <br />bi givo aulhority to vioiale Or cancel Ih� provision ol any other slate or loc�l law reyula�ing wnstruclion or the peAormance ol <br />��.onsiruction. That I am aulhorizr.d hy tho owner ot this proporty lo perfonn Ih� work Inr which application is madtt and I comply wilh Ihn <br />tiCde CaNr:�,�lurs L���v 1i327 RCW aq�1'L9fi.200 WAC. • <br />:�,. S" "z �� <br />% � , <br />Si�naty . IOwny .oNracton ulholr, �enl at� yL <br />