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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLiCATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM �J ��/ --�� <br /> SITE ADDRESS PARCEL TAX I.D./ PERMR s <br /> 2O2o Lal�e R'•$ � 2gx�52`l ac�Zdl_� 3 0 0�-� `�� <br /> LE LOTNO BLOCK TRACT J.� <br /> DESC. q Q�QnS �j(�vPJ/ ��+ � <br /> OWNER ADDRESS CffY('JP PtIONE <br /> htivw (,�c1� f�e1r'�k'fS, U.L ("Ilt�- r,cu� � �+.z..: �5a,w D�c�,CP� <br /> 7ENANT NAi�`��7� T` COHTACT FOR PERMT PHONE <br /> 1�jk ; -� '�j I� Mlw?�c._�yw�+�- � - �6�{d I�-- <br /> �p��� � ����DR I55 N � � CfTYlLP '1HONE <br /> ����n ��'5���/{�,�y�V�C. <br /> CONTR. ENSE i *��' '�_ � Z� 1.,'�- �yr� �Z�'���{� <br /> W� Lr.��.. <br /> USE OF BUILDING � �HEAT 50URCE ONT/RACT PRICE OF W� <br /> �y{ll.tr�� I _vElectric _Gas_Other I � (O/� �� <br /> WORK DESCRIPTI6N <br /> p4fwcw s'�-sldu� t y�ri-s � Ezr(u�i�,s <br /> PI.UMBING F/ � M�CHANICAL p/�,. <br /> NO. TYPE OF Fll(TURE OR ITEM NO. TY^� °FIXTURE OR ITEM <br /> Toilet A/C-air handling uniLs <br /> Bcithtub Forced air systems <br /> Lavatory(vrash basin) Gas piping <br /> Shower Walar healer <br /> Kitchen sink&disposal Gas fireptace <br /> Dishwasher Gas iartga <br /> Cbihes washer Clothes dryer <br /> leundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Badcllow praventer � Hoal pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeradon <br /> Grease trep Woodstave <br /> Roof drains O[her <br /> Other — <br /> CfTY OF EVERETT LOCAL SALES TAX COUE IS 3705 <br /> � I hereby ceritify tliat I have read and examined fhis application and k�ow tlia same to be true and cortect. AI provisions ot Iaws and <br /> ordin goveming lhis type ot v,orlc will be complied with whether specifiod herein or not.The grandrg of a parmit does�rot presume <br /> lo give au 'ty to violate or cancel the provision of any other state or tocal law regulatlng construdion or the perfortnance of <br /> consWction. at m authorized by the owner of this property to perfortn the waic for which application is made and I cort�ply with the <br /> State Contrnd . CW ard 296.2(10 WAC. <br /> Signaturu o( onlraclodA Uwnzed Agent � ��� <br /> 1�Z <br />