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P��RMIT APPLICATIF,N <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 -DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br /> �SITE ADDRESS-� PARCEL TAX I.D.� PAER�,M,I1T A <br /> 1 �oa- Gwr�' �►'C/��(� ' 6�/ <br /> LEGA L07N0. BLOCK TRAC7 <br /> DESC. <br /> --N ADDRE P H N <br /> ��a1�� 4r-.(�,_�„e!(Ct. l�R�� ��)��►2 �F�' <br /> TENANT NMIE CONTACT FOR PERMIT p�E <br /> _ �/erl�ZCh�I I 7rM �SP,u1 [�ZO(��25"S'U$d L <br /> CUNTRACTOk ,�/(y((/ ADDRESS <br /> ...__. . . f.JA- �1 f �AU/II'P–S�.OICMKS��CITYRIP PHONE <br /> 4 2v3a�r..� <br /> CONTR.�UCENSER /�, a���fI1Ul�IP �IZS <br /> - w/��C1Tc �Grt�I��4 �.a"5�`�`�r ie°� 94'a7� yif3-7S^nfl <br /> USE OF BUILDING �p �gOURCE fl�G^�, CONTRACT PRICE OF WORK <br /> iT�._. <br /> rG'��'Ail�I.Y�K��l�17S Vt , _Ele1 Gas_Other �� SV U <br /> WORK DESCRIPTION , . <br /> /P��(�-e, £x�s-h� �l�era++��c���s e�v� �n'► a/IC �,",�`S <br /> PlUM81NG MECHANICAL <br /> NO. TYpE OF FIXTURE OR ITEM NO. TYPE OF FDfTURE pR ITE►�I <br /> Toilet <br /> BaMtub � aC–airhandlingunits <br /> — ��a� _ Forced afr syatems <br /> _ ry(wash basin) Gas pipfng <br /> _, Shower Water heater <br /> _ IGtchen sink&dfsposal Gae fireplace <br /> _ Dlshwasher Gae rarpe <br /> _ Clothes washer Clothes dryer <br /> _ Laundry tray Ranpe hood <br /> _ Sink(service/bar/mop/etc.) Exheust fan <br /> _ Backflow preventer Heat pump <br /> � _ Urinal Un(t heater <br /> _ Drinking Fountain Boiler <br /> � _ Floordrain Refrigeretlan <br /> i = Grease trap = Woodsrove <br /> _ Roof drains Othar <br /> Other <br /> i — <br /> CITY OF EVERETT LOCAL SALES SAX CODE IS�103 <br /> I hereby ceriOfy that I have read and axamined this applicatlon and know the same to be Uue and cortact, q��provisions of laws and <br /> ordinaces govemi his type of wark will be complied with whether speciffed herein or not The grantlnp of a permit does not proaume <br /> to give authonry iolate or cancel the provision of any other state or local law repulaOng consWction or the perfortnance of <br /> constructlon. I am authorized by the owner of this property to perform the work for which applkatlon is made and I comply with the <br /> Sta Law 18.27 RCW and 296.200 WAC. <br /> r a �u o <br /> i Signa re wneuContractaNAuthonzed Agent ate <br /> I <br />