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PERMIT <br />i <br />SITE ADDRESS <br />PARCEL TAX I.D. R <br />PER '# <br />LEGAI LOT NO. <br />BLOCK <br />TRACT Od,R1''SUBDIVISION • <br />DESC. <br />(Y , lVvtfr}CI I-,cr,.e, CcLA C(rt i[1 <br />OWNER ALJUHEW ry P <br />n <br />?312Ir 6'CktciI,Jntj �).'rk''X,1 C JP/eff rjQ2u1 .. IS 211 yiW <br />l <br />i ENANT NA1.1E CONTACT FOR PERMIT PHONE CI ZS i `it t I %} IU K 3tt2 <br />I LI�jYUrj[ `�Clnc•V'F'✓ EMRII�L�71�1'., e r r I'1d'• <br />ZoATRAi;R1 , I�r,,,5t✓t 4..a Qcl LtdVln IrUrr L.y;b (rrrir.yai nEl <br />1$�iOC� r,Av-(. NUJ <br />CONTIi. LICENSE N <br />L�2 r.1�,L•Ff `met-elrn� rlsi� r <br />USE OF DUIjDINO <br />HEAT SGURCE <br />CONTRACT PRICE OF WORK <br />C1CI�,cIVr1 <br />I <br />_ 6as _Other <br />—Electric <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />Bathtub <br />1 <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heeler <br />Kitchen sink 8 disposal <br />_ <br />Gas fireplace <br />Dishwasher <br />Clothes washer <br />_i <br />Gas range <br />Clothes dryer <br />� <br />Water heater <br />Range hood <br />Sink (servicelbadmop/elc.) <br />� <br />Exhaust tan <br />Barddlow preventer <br />Heal pump <br />Urinal <br />_Unit <br />heater <br />_ <br />Drinking Fountain <br />Floor drain <br />_Boiler <br />Refrgemtion <br />-- <br />Grease trap <br />W.wdstove <br />Root drains <br />Other__ <br />Other <br />A <br />---- <br />CITY OF EVERETT LOCAL flALFB TAX CODE 19 71e5 <br />I hereby ceritily that I have read end examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />if give authority to violate or cancel the provision of any other elate or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application Is made and I comply with the <br />Stets,\\**Cpnlractors Law 18.27 RCW and 296.200 WAC. <br />5`lAnetu a of Owner/Conttaclor/Aulhodzed gent at�— <br />i <br />APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 —FAX 425-257-8857 — www.everettwa.or0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />aYT <br />