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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257•t1857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 9 �-O�`�2 <br /> S17[ADORESS PARCEL TN(I.D./ P �M�7 fl C� _D I� <br /> � (�V t <br /> LLG LOT N0. BLOCK TRACT OR SIIBUM910N R <br /> �E3C. <br /> OWNER AOOK6 CITYIZIA —T'HONE <br /> ��. �.���.�- ��3o W �0.s�,� �d� E��� ��.�'aa • 3ot <br /> TGNANTNAME CONTACTFORVERfMIT PHONE � (�`�, �l�Fi �4�`I�� <br /> I�0.i M. t �u Cy c�'�.iv..r'� Eaxai.�0.+�YU<.�:�' r�'tir.�1 <br /> TOR �,n,�y�/..f\ �.�1 Y� AUUR S l�i^1 5 I CI 1 IP PHONE — . <br /> p� 5��,��� �r� :��IE �Ao ���.� <br /> c�F��6 <br /> CON7R.LICENEEM �CLI,X`\_ 0.� 1'� �(� " <br /> Y` -i <br /> USE OF BUILDING HEAT SOURCE 1 CONTRACT PRICE OF WORK <br /> ^}� � _Elecl�c �Gas_,Olher I*a`�� <br /> �IIIORK DESCRIPTIAN <br /> Qp�� -e.�.l s�►�1 q� � �'r ►�c.c , L�, ��,�.. ��,� L,� -e.. <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE Of FIxTURE UR IT[M N�. TYPE OF FIXTURE OR ITEM <br /> Toilet NC—etr handling units <br /> "— Bethtub �� Far�ed air systems <br /> v Levalory(wash basin) I Ges piping <br /> Shower _�, Water healer <br /> Kitclwn slnk 8 disDosal ' Gas 6repiew <br /> Dishwaehcr Ges renpe <br /> CIO1he5 WO;hCf _' CIOlh09 tlryCr <br /> Woter heator Renpe hood <br /> � Sink(servicelborlmop�etc.) _ E#�eustlan <br /> Uackflow preventr.r _ lieat pump <br /> Urinal _ Unit t�eatcr <br /> DnnklnA Fountaln �oiler <br /> Floor droin _ Refrlqeration <br /> _ Greacalrap _ Woodstove <br /> Raof dralns _j Other <br /> Otbxr — - <br /> CITY OF EVERETT LOCAL SALE9 SA%CDUE 18]I05 <br /> I hemAy cenily thAt I have reatl arxl examined fhie application and know the same lo Oe tNe anC concCt. All provisians otlews and <br /> ordln2na!s goveming this type of work will be complied with whether spec�M1ed herem or not. The(7rontinp of a pertnit dce&nM presume <br /> to glve authorlry to Nolnte ar cnncet the proNslon of any other state or local law rnpWaling coneln�cdon or the peAnrmence ol <br /> con�t r.tion.That 1 em auUiodz d by the owner oi this property to Da�orm the work for which epphca6on is mede end I eompty with the <br /> %�nte .ontrecton Lnw 1li.27 end 2 8200 WAC <br /> � 13 ► <br /> - aldrs of nedCUnlreW r! u ivtlZe Agont Dele <br />