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---------� ----- — <br />P�RMIT APPLICAT�ON <br />SITE ADDRESS <br />/ C Tu sT <br />LEGAL LOT NO. <br />oesc.� <br />OWNER — <br />�fc�9L� � �l.ht <br />TENANTNAME <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-fi810 — FAX 425-257-J857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. J! PERMIT # <br />E e�dcK TR � OR SUBDIV S ON ODC% ^ C90(F —pQ I l' U�I l 0- c'� 5 <br />. .� . _ .. � . _ <br />.Sam� <br />�� �ric-+, Co �St <br />CONTR. UCENSE N <br />lyl <br />CONTACT FOR PERMIT <br />� <br />„ <br />gboo �4�a�t h7,��-!oa <br />400V� 353 r I/ 1 D <br />PHONE y�s �a� -as� <br />wQ,t u �-�i ��s �a �- a s� �s <br />— L. RR � � � � ��H <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />Re��iC�0��:1 I � Beclrir, __ Gas __ Othcr I :./ e �"" �O <br />/ 0 �'.J / <br />WQRK DESCRIPTION <br />�cPluc� Ckli��c-F,� �/�mb�%►y �,��n�' G��� F.�.hc�st Fns <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />! lotl��l <br />f3athlub <br />Lavadory (wash b;�sin) <br />Shower <br />Kiichen sink 6 dispoenl <br />5 <br />Dishwasher .. <br />Cl,dhes washer <br />w,,��„ �,��,���� <br />Sink (sorvic�elbarlmoplr,lc.) <br />Backllow provculor <br />Unnal <br />Dnnking Fountain <br />Fl.�or drain <br />G« �aso Irap <br />Ruof drains 0 <br />Olhuf <br />NO. � TYPE OF FI%TURE OR ITEM <br />A/G - air handlinc� unils <br />Foroed air syslems <br />Gas pipin� <br />Wa�cr hoaler <br />Gas Iirepiace <br />Gas ranga <br />Clothes dryer <br />Rangehood <br />Exhausl lan <br />Heat pump <br />Unit hcatar <br />Boiler <br />Refrigcratio�l <br />Woodslovo <br />Olhar <br />__ CITY,QF EVERETT IOCAL SALES TAX CODE IS 7105 <br />I hnroby �:eritily Ihat I have read anA examined thi, ap�711calion and know ihe samo lo be iruo and correcl All provisions of laws and <br />ordinar.r.s governinc� lhis lype ol woik will ba complied wilh wh��thor speci�ied herein or nol The yranling ol a permit does not presumo <br />to �ivo aulhorily to violato or cancel Ihe provision ol any other slote or local law requlatin� construction or iho peRormanco ol <br />construclinn. Thal i am aulhorized by Ihe owner ol �his property to perlonn lho work lor which applica�ion is mado and I compty wilh the <br />S�alc Conlraclors Law 18.27 RCW and 29Q200 WAC. <br />��'1�-- /G—(�- o <br />