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� PtF?i�IIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> 425-257-6810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS PARGEL TAX I.D.11 PERMIT p <br /> I5u 3 Pr1Ci�iC �v�. Cv£�,'cTT `l8.ac� OoG45 17S'D I 2 0o C)CJj -nl/ <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION tl <br /> DESC. i2 � Z� �I � SCc f��TrICNGD <br /> OWNER ADDRESS CITYIZIP PHONE <br /> sKcro� I�r�tL C5��1"+ti l7G') L.��i;�; sr �l�o c�tricr� , i.-1 9a>�� I C�zS)1s1 54c� <br /> TENANTNAME I CONTACTFORPERMIT PHONE �jfJy)8d%+ - ��5CG <br /> I I <br /> , nnn����iiHc��1H��� riA�llCdcoitu��u .S�Itii LHUNLI E-MAIL �li�ti�$�Ctl"�Ilu��t�.Lon <br /> �SRT��'bTb ��2ccU dUiLOL�:s �iT'rIDR�H� <br /> �7�'��l VILL,��Ci� ����Z� ���lY( [4a.5)bY�i - d'•��C� <br /> CONTR.LICFNSEM ��CUNL<�� � �Z 5��� SL•TL I�'` <br /> gu����c,w-i lB�oG <br /> USE OF 6UILDING �dh���1C{tGiA�-- HEAT SOURCE I CONTRACT PRICE OF WORK <br /> i�pG�n uNIGN _Electric �Gas_Olher �. `1�GGL <br /> WORK DESCRIPTION <br /> �.���'I �� ws,.�u. B1cK��� s�t,Ns c/„ q. •,,ocs rr �nC C-'xic ' C.INnPY AS y�c;Putvcp �n� zH� S�GN <br /> l�t�il����ti "t11 Slb,w: r+c�.r �vcn�r,r� �NC Ih�'NG'�'� f��"T�•'N Pcn "INC C�(GOI`f UN�N� willa�i w.1i AY��'1�obEP <br /> lN �\ I�lu��cu: rt�:nn�l ��hC t'>.��Kb� � SIGNS .�N'L 17'viN;i�cGN� V�Nx6 -1Q�'6iLD iv �/� � �'��,ti Gl�ii. ❑Ht S,F <br /> F��'Crl c� >�GNs �ll� �15 I�r�6r...S (1)Iq.,�xh5.5���',�pf6slAv�uoN-Li-T; �1)�4�XICJ�S"nn�n�ri : 5o�li Tot.IG: 31 Si6Na t <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood - <br /> Sink(service/barlmop/etc.) _ Ezhaust tan <br /> Backflow reventer Hea�pump \ /,, l <br /> Urinal P _ �Unit heale� J /u' ��� <br /> DrinkingFountain Boiler � / � � ,r�.j�l <br /> — � Refrigera i rS � / <br /> Floor drain 9 <br /> _ Grease lrap L_ Woodslo�A - `� /�J�� 7� <br /> Roof drains ,L_ Other � � � <br /> ,___.. <br /> � Other L� �� � �— <br /> — � � ����(�. 4�° <br /> CITY OF EVERETT LOCAL SALES SAX CODE IS 3705 <br /> 1 hereby certify that I have read and examined lhis application and know the same to be true and corred. All provisions of laws and <br /> ordinances governing this type of work will be complied with whether specified herein or not.The granting of a permil does not presume <br /> to give authority to violate or cancei the prevision ot any other s�ale or lo;.al law regulating construction or the performance oi <br /> consliuction.Thal I am au•norized by lhe owner of�his property to pertorm the work for which application is made ai7d I wmply with the <br /> State Conlr�ctors L�F7i FCW and 296.200 WAC. <br /> --=�:�G, 7/s/� <br /> SignaWre of OwnedCoMractor/Authonzed Agent Date <br /> ��1 <br />