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OCT-23-2008 09:SSR FR011:ESML 253-735-9352 T0:14252576857 P.2 <br /> � ( <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTE�FROM 8 AM TO 4 PM <br /> SREADDRESS PARCELT/U(I.D.�qZOC3DZ�SODZ Iu11�T�M <br /> Z3oo �'l�l� �RE�K I�Kt� /-oT 5A� z80 02 3 00 ? � o �/D <br /> LE�A LOTNO. BLOCK TAACTOHSUB�IYISIONR <br /> oesc. 5 $'Ej�u/i9- �'.�%K%F� <br /> OWNER AOORESS . CIiV21P PNONE f,�� 6 .• s <br /> �� U S n! W L L c.- 9�5 11 ��'H AV� S•�. 3E1.1-EYu� Wi9 9f�oo <br /> TENANT NAME CONTACT FOR PEHMIT PMONE�s'3„��'j j-��// <br /> S�Ecu44Tl�E '�Kan�r S�gL� GuR�` C�r«t3E�T E�,a�z5i_���-�•3��. <br /> �e� �-,��,�,�c. ��. ��� x • 33ls�Si .z,s�-��s-s3y/ <br /> CONTA.UCFJJSEM ���� , , 1� Iry�� <br /> (�t/ l b <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK \ <br /> 7/�l� %��� I X Elodric ,�,Gas_Olhnr I !� QW,� <br /> / <br /> WORK DESCRIPTION <br /> �9'1j p Z �neooms -rt� '�+-n!t' S�A� 1n� C�-� <br /> �,� �'v fv�� 'r�7Vn�v7� S�rL TT. �'� L��Se— <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXfURE OR 17EY NO. TYPE OF Fl7(TURE OR REAI <br /> _ Toilot A/C—airhandlinpunils <br /> Bathlub Forced air systems <br /> '� Lavatory(wash basin) Gas pipinp <br /> Shower Watar heator <br /> _ Kitchon sink 8 disposnl _ Gas firepleca <br /> _ Dishwoshor _ Gas range <br /> Clolhos washor _ Clothes dryer <br /> = Wnter hoatar Ranpe hood <br /> _ Slnk(service/bar/mopletc.) Exhaust fun <br /> _ BacMiow provantar Hoat pump <br /> _ Urinnl Unit heater <br /> Drinking Founlain Boiler <br /> _ Floor drain Rofriparation <br /> _ Grease trap Woodslove <br /> _ Root dralns � _ Other <br /> Olher <br /> = 1 — <br /> C�TV OF EVERETf LOCAL 9ALES TAX CODE IS 3105 <br /> I horoby ceritify that I have road end oxnminod this applicalion nnd know the same to be true and correct. All provisions of laws end <br /> ordinacos governing fliis typo o(work will be complied with whothor specified herein or not.The granNng ot a permit does not presume <br /> to givo aulhoriry fo vioioto or cancol tho provlsion of any olhor state oi�ocal lew togulntinp construction or tho poAormanco of <br /> construclion.That I am authortzed by the ownar af lhis property to perform tho work for whlch application is made and I comply with Ihe <br /> State Co trectors Law 19.27 CW antl 296.200 WAC. <br /> 1�� ����--�%� !�-zZ-og <br /> SlgMature ot Ownar/ mrnctor ut onzo gent ato <br />