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. , <br /> 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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.it PE�iMIT A <br /> 17c3 i�ciFic AvE. iur�err, ��A 9S�c� � CK�(�t- �i'7 i4o� 2co �;�1`�/Z/�D� <br /> LEGAL LOiNO. BLOCK TRACTORSUBDIVISIONN <br /> DESC IL ZI '71� Se Ali�kncD <br /> OWNER ADDRE55 �i'•�"� ^"'^� <br /> '�Kcli qL Rr�l �sTA�i 2�07 C�l�r}Y Abr �Izcti` E�4�T( y.Y2ol (�i-�ti}25�- S�+Do <br /> TENANT NAME I CONTACT FOR PERMIT � PHONE(425�$�'� –��j Q 6 <br /> s.q�til CNUt+G �..i -ri�F PRIFT�ic�� <br /> �`cMn��N�Tt� ;itrlLTMc.I� Fc�u.a6 C�i�T�p n Ai:ciutr:�rs e�a� s�����dr�{'F�i,�rY, com <br /> C O CI Y I <br /> ����u 6t yf,�:cT�p� <br /> CONTA,LICENSE R <br /> USE OF BUILDING I HEAT S RCE CONTRACT PRICE OF WORK <br /> IS�Sin�C�S Pnbp S[D uS[ — <br /> Electnc Gas_Other Ia ������ <br /> WORK DESCRIPZION <br /> IYTEr21c�' rlLMovLL uF,hNExlsilNG� ,j�']0 S.F Bu��oiNL �-/ �IM��rD LxZTR�uR weRR. <br /> CxtRw�� w:kr. �r��u�xs xrri�s �b .(1tr1 NcRLcN rF �HC d��W�N4, Nrt,, ('.QINT, LIGNi Fir1�RE5 , �w :trut � <br /> ��15-ZS CN IHL Sipl:iv.l4C�r'VGw I�r�iC11;7[(LC1� L../ CAN:1'�( 1�jJJ ("UtK1UC� {U,-S�f�ll'IN4. �N7Ei21UR 4`Cl2k INi1.4i.�LS <br /> Irw �iG�NT NU w'Au>. cqsc w;Rk �WJ FiN 5 i� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _, NC–airhandlingunits �' ��� �'°�� �'tAM�T <br /> Bathlub _ Forcedairsystems ��LI�R�D S�dMITGIL <br /> �_ Lavatory�wash basin) Gas piping <br /> � Shower ��_ Water healer <br /> � Kitchen sink 8 disposal � Gas tireplace <br /> Dishwasher Gasrange <br /> Clot�es washer. Clothes dryer <br /> .Waler�heater � i X�S��ItJ�'� _ �,Range hood <br /> _j_ Sink(ser�ice/badmop/elc.) _ haust tan <br /> Backflow p venter _ H t pump <br /> .� Uridal _ Unit eater <br /> _ Drinkmg Fount ' _ Boiler <br /> Floordrain _ Refriger "on <br /> Greaset? _ Woodstov <br /> Root drain _ Olher <br /> Other — <br /> CIN OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceritify that I have read and ezamined ihis applicatio�and 4now the same to be true and correct. All provisions of laws and <br /> ordinaces goveming ihis lype ol work will be complied wilh whether specified herein or not.The granting ol a permit does not presume <br /> to give authorily to violale or cancel the provision of any other state or local law regulating constmction or the pedormance of <br /> wnstruction.That I am au}�wrtz d by the owner of Ihis property to pedorm the work for which application is made and I compty with the <br /> Slatc Coniracto ' Law 9.27 RC nd 296.200 WAC. <br /> � �� � I�� ���9 <br /> � SipnaWre vner� ntm 6rl u�honzed Agen� D te <br /> � �/3 <br />