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P�RMIT APPLICATI(�N <br /> CITY OF EVERETT PERMIT SERVICE'i <br /> 3200 CEDAR STREET, EVEREI�',WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everetl��ra.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �b r,�-P> 4 <br /> SITE ADDRESS PARCEL TAl(I.D.K PERMIT� <br /> Z �� +�Ewrrt A��cC cz�6q�G�y oozoc� SO��-(;v� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION K <br /> DESC. Z Co�� l SW� �- W�LLS Z ^�O +4DD <br /> OWNER ADDRESS ��TNR�P PHONE <br /> � b l.VryO Lt,.C. 2a�xo �w.-�-�Avc �rnrrr,wa ��.01 zA�-�t�y-4ss9 <br /> TENANTNAME CONTACTFORPERMIT PM�E4�f- g�('p�Z;q` <br /> FjA.IFFI�SC�toAi�+�oW�,+E�CY�C.I..�- I MAX c1ErlSEr1 e�a�62lt=F�NSW�•+�gAO <br /> �� -Ab6iF€S� <br /> �VIA�C c�Eh�SCN 1 a0'Z, 13i ST Vit nG LaM<< S7C�cr+�Vk �ZS$ 42S-a76 Z ` <br /> CONTR.LICENSE k <br /> N/A Te-�rs4..��' �►g Ca., ,—itacTo2 <br /> USE UF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��NE�y �-jP�-���� �� I �Electric _Gas_Other � �o �� <br /> WORK DESCRIPTION <br /> 1Lew�.oVt �X�SZ�n� S� �N FKa�wi Frtorr� oF i3�1�`�7iivG �t•-�►� <br /> '2�Q�Ac.E w �-T�t r•l E W St fs r�l <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR 17EM <br /> �_ Toilel _ PJC-air handling unils <br /> Bathtub _ Forced air systems <br /> j� Lavatory (wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kilchen sink&disposal _ Gas fireplace � <br /> Dishwasher _ Gas range ,( <br /> Cbthes washer _ Clothes dryer (�, � <br /> Waler heater Range hood ;� <br /> � Sink(service/badmop/etc.) � Exhaust fan <br /> Backflow prevenler _ Heat pump <br /> Urinal _ Unil heater <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Refrigeration <br /> Grease Irap _ Woodstove <br /> Roof drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y lhal I have read and examined lhis application and know the same to be hue and cortect. All provisions of laws and <br /> ordinaces governing this rype ot work will be complied wilh whether specified herein or noL The granling of a permil does not presume <br /> to give authority to violate or cancel the provision of any other stale or local law regulaling construclion or the performance o( <br /> construction.That I am authorized by the owner ot this properly to pedorm the work for which application is made and I comply wilh lhe <br /> Slate Conlraclors La� 18.27 RCW and 296200 WAC. <br /> � r.� l/ l�v�--- 9��t�o `I <br /> Si�naturo o(OwnedContraclorlAuthonzed Agent Dale <br /> ��a- <br />