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; <br /> P�tRMIT APPLICATION <br /> CITY OF EVERET7' PERMIT SERVICES <br /> 3200 CEDAR STREET, FVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PAHCF.L TAX I.D.# PERMIT <br /> 14 w cas��lo �a�� - �s ocra651 0 lol 6 '�o�- �� <br /> LEGAL LOi NO. BI.00K TRAC?OR SUBDIVISION N <br /> DESC. <br /> OWNEfl ADDRESS CITViZIP PHONE <br /> �MtILSE�" �'Jk�.k C�Noorn�rl;�Ms 143n WCAs�►� l�V �ft�tC °182�} <br /> TENANT NAME CONTACT FOR PERIM'IT PHONE � IpdZ �II <br /> "`^"K�iI� CDRk I VIN�IIG PY�' Fl�L8�1f ���.Ma�JiM@4a1�uwACWIQsxS. <br /> aaar�sb .�'$D � <br /> CONTR.LICENSE M <br /> USE OF BUILDING � — HEAT SOURCE CONTRACT PHICE OF WORK <br /> CO�������m Electric ____Gas ____Other � ``���� �— <br /> WORK DESCRIPT�ON <br /> {Zy�Cx(E � �t'�A�E si��c� p.s� � r.�1.a'�1 �uJ&�PF R�r'Mrzs <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ItEM NO. TVPE OF FIXTURE OR ITEM <br /> loile� 'NC�s air handlin�Unils <br /> 13athtiib _. Forced air systems <br /> , . Lmalory(wash basin� _. Gas piping <br /> Shower � Water heater <br /> -- <br /> __ Ki�chen sink 8 disposal _ ____ Gas�ireplace <br /> Disho sher Gasrange <br /> � CIoU�es washer .. Clothes dryer <br /> – - <br /> Waler heatcr _._ Range hood <br /> _ Sink(service/badmop'etcJ . _ Exhaust lan <br /> , _ Backllow prevenler __ Heal pump <br /> Urinal Unit heater <br /> ._ Drinking Founlain _ Boiler <br /> Floor drain . Relrigeration <br /> . Grcase Irap Woodstove <br /> � Rool drains Olher <br /> - – Olher .- _ - --- — — <br /> CITV OF EVERETT IOCAL�ALES TAr CODE IS 3105 <br /> 1 hereby ceritity that I have read anA e�amined Ihis application and know the sama to be Irue and correct. All provisions of laws and <br /> adinaces governing Ihis type ol work will be complied witli whelher specilied herein or noL The granting ol a permit does not presume <br /> lo give authority lo violate or cancel the provision ol any other state or local law regulating construction oi the perlormance ol <br /> consiruclion. That I am authonzed by tLe owner ol this property to perlorm Ihe work lor which applica�'on is made and I comply with the <br /> St Conlractors Law 18.27 RCW and 295200 WAC. �jp'1 <br /> W (� 23 � <br /> nat� eol0 ien omractonAuthonzed gent ate II� <br />