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i <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 ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.M PERMI�If <br /> 03 c. �, c wq � o - vu <br /> LEGA LOT N0. BLOCK iRACT OR SUBDMSION• <br /> DESC. <br /> OWNER ADD E9S CITYILP PMONE <br /> S,�o7-i�u�. � �sl��C 2��- Cal by Ru� sTE i a�•o �'c�n�s1'�t...�4 4 8�6 <br /> �ANT NMAE CONYACT FOR PERMT PMONE yzj g�'. (�uo <br /> +�+m�.+��,+,' Hr.x+-a� c.x� <br /> l=�or.,�.aL c.eF.o/r�tw..J �'✓D H�t�%��" e,�N��tovr�''lnas��st � <br /> � //!G.C4y <br /> ,si�,,,r' �ss�c.;9�c ��n�c. 6&2s' /�C��''^�' Sr�ia� /�/..w„i <br /> CONTR.LICENSE• c„x}., 9�o s z y2 s b'8S 6i�d <br /> ��6+��L �!c o94 Me <br /> USE OF BUILdNG HEAT SWRCE CONTRACT PRICE OF WORK <br /> (�-�G�� UNfU/J I _Eledric _Gas_Other 'f",Z,�UGD — <br /> WORK DESCRIPTION <br /> J'�E.Pic,q� d- insl�4u. 2 Bu�l d n� Sr�.�s d� I smtL( D�c7r�.�.Q <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF flXTURE OR IT[M NO. TYPE OF FlXTURE OR ITEM <br /> Toi�et A/C–air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposai Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Cblhes dryer <br /> Waterheater Range hood <br /> Sink(service/barlmop/etc.) Ezhaust fan <br /> Badcflow preventer Heat pump <br /> Urinal Und heater <br /> Orinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7A%CODE IS�105 <br /> I hereby certify that I have read and examined this application and know the same to be true and corred. All provisions of lahs and <br /> ordlnances goveming this type of work will be complied with whether specified herein or not. The gran6ng ot e pertnit tices not presume <br /> to give aulhority to violate ar cancel lhe provision ot any other state or local�aw reguiating construction or the peAormance of <br /> construclion.That I am authonzed by the owner oi this property to pertorm the work for which applicatlon is made and I comply wifh lhe <br /> State Con o Law 78. RCW and 296.200 WAC. <br /> �.ssc9�s y�3v�o <br /> Signa re o vmed ractor/Authonzed Agent ° Date I <br /> ►/L � <br />