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SITE <br />� <br />� <br />C1E� � <br />� <br />P�r2MIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � 2c�� j(�3 �� <br />2ES5 <br />gem .� <br />LOT NO. <br />Co <br />/Zo�G=aT LEE <br />TENANI nr...�c <br />CONTRACTOR <br />CONTR. LICENSE M <br />PARCEL TAX I.D. # <br />sw. ooa949ac�oo�oo <br />BLOCK TRACT <br />PL..ar oP eccnFiE-c.o P�[,¢K <br />/0933 � l86 �i •sT• <br />CONTACT FOR PERMIT <br />ARMANLY� LEy✓4 <br />ADDRESS <br />29 <br />RE'NfiN <br />PHONE <br />253-G53-G�/S <br />CITV2IP PHONE <br />��'G / //) r 7 / / ' �" <br />USE OF BUIL�ING HEAT SOURCE CONTRACT PRICE OF WORK <br />SFQ . _ f.loclric � Gns ___ Olhc�r <br />WORNDESCRIPTION cONSj/2(JGr/ON aF' TWa 5FK . O�Ti4cNE0 <1N0 EA�N <br />UN/T W/7'H ONE �!2 C,�A24GEaTTAGNEO <br />PLUMBING MECHANICAL <br />NO. I NPE OF FI%TURE OR ITEM NO. I TVPE OF FI)(TURE OR ITEM <br />Toilet I1 ! <br />Ba1hWb � � <br />Lavalory (wash basm) I � I�� <br />Shower <br />Kilchen sink 8 dis�wsal <br />D�snN�sne� <br />Ciulhes washer <br />Walei heale� <br />Sink (serviceN�r/mop/etc.) <br />�ackllow preventer <br />Urinal <br />Drinking Foun!ain <br />Floor drain <br />Grease Ir�p <br />Roof drains <br />Other <br />9=� <br />_L <br />_L <br />_L <br />�� <br />A/C - alr handling unils <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas lireplar,a <br />(',as range <br />Clothes dryor <br />Range hood <br />Exhaust fan /Y1� <br />Heat pump <br />Unll heater <br />8oiler <br />Refrigeralion <br />Woodslove <br />Other <br />CITV OF EVERETT LOCAL SAL�S TA7( CCDE IS �705 <br />I hereby cerAify Ihat I have read and ezaminr,d Ihis application anA Anovr the same lo be lrue ond cortecL All provisions ol laws and <br />��rdinaces governing lhis type ol work will be complied v.�ith whether specilied herein or not. The granling o( a permil does nat presume <br />lo ylve aulhonly to violale or canr.el �he pmvision ul any other state or lucal law regulating construc�ion or Ihe peAoimance ol <br />r.onstruclion. Thet I am a�Ihmizr.A by the owner ol this pioperty lo perfurm the wmk for which applicelion is made and I comply with �he <br />Shle Cenlractors Law 18.77 RCW and 296 200 WAC. <br />�. <br />���� j ��� <br />`�z <br />;�� �f��1 `������f�-- ------- -- <br />