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� P�RMIT APPLICATIC�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 <br /> SITE AUDRESS � PARCEL TAX I.D.M PERMIT �7 <br /> I W �ws� � �ak'D - 7 od�6s1 0 lol Q '�0�- � � <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNEfl ADDflESS CITV/ZIP PHONE <br /> �N1L11-sE'I' �'J�.k Cd�Dorn�rJ��Ms 143o WCAS►►� � �ft�tC °I82�'} <br /> TENANT NAME 1CONTACT FOR PERMIT � " ('HONE � (�62 *o21I <br /> �Uf1�/G crFi I �IIM�WGP� FM11�.Pn.+' ' ^+`� _ ""E•MAILJIM�►`w��/N�1LC`{�Q�7f. <br /> L`aATFi7Cl'' �D � — <br /> CONTR.LICENSE M <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF YVORK <br /> (,0��1'11�►1y�11'� Electric __.Gas_ Othcr d 2 �0� � <br /> -- � 1 <br /> WORK DESCRIPTION <br /> �2�fE � �-Gl'�w6 S'iD»SC.q p.�+� � i�l,a�� L�J&�PE R.�'t'I.�2S <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> • ToiJeh� ' . . q�P-nirhand�ingumts , <br /> Bathtub ' � "� _ Forced air syslems <br /> ---�� Lavatory�wash basinl .___ Gas piping <br /> Shower __ Waterhealer <br /> _._ Kilchen sink R disposal .. _ Gas�ireplace <br /> Dishwasher __ Gas range <br /> �� Clothes washer _.__ Clolhes dryer <br /> Water heater _._ Range hood <br /> _ _ Sink �scrviccibadmop'aal .___ [xhaustlan <br /> _ 6ackllow prevenler __.__ Hea�pump <br /> Urinal .__ Unil hcalcr <br /> � Drinking Founlain ___ Boilcr <br /> Roor drain __ Relrigcration <br /> __ Grease liap Woodslave <br /> Rooldrams .__� Olher <br /> Other <br /> CITV OF EVEflETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby centily that I have read and eaamined this application and know Ihe samo to be Irue and correcl. All provisions ol laws and <br /> ordinaces goveming Ihis rype of work will be complied wilh whether specified herein or nol. The granling ol a permit does not presume <br /> to give authoiity to violala or cancel the provision of any olher state or local law regulating construction oi lhe performance ol <br /> consiniction. That I am aulhorized 6y tha owner ol this p�operty to perlorm Ihe work lor which application is made and I comply wilh ihe <br /> SI Conlracrors Law 18.27 RCW and 296200 WAC. �'1 <br /> W (� 23 <br /> nati e ol O �en omraclorAulhonzed Agr.nt ate I 7� <br />