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PErtMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8B10-FAX 425-257-8857 -www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (.� �, -��p <br /> 81TE ADDRESS PARCEL TN(I.D.N PERMI <br /> c� c� Co°I Lac oo � �`� 3 7 <br /> LEOA LOT N0. BLOCK TRACT OR SUBDM810N� <br /> DESC. <br /> OWNER ADDREBS CRY21 PHONE <br /> l)lUhqe, 8.�"}4 �wK_ !�A SZo f�• � �. �Clt#' 96?n3 <br /> iENANT AME CONTACTFORPEFGIR PHONE 4Zs••.��•�13z <br /> I �'�'1 Q�A11C11 E#ANL Kd►IGSO�kIOB�7��01� <br /> �TF LO Hl�• <br /> �.�k4st�d ti�.re�.+o¢.5enrisS �gpfo Y►�Rrw.c u�c�Jpwo� �� �{y,r-73-�- � <br /> CON7R.LICENBE t1 . <br /> �Jcsr �. 027C.F I�W1fkSl�►1lG �27I <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �"�1�rl jjA-G _ElecUic _Gas_Other �2�7 � �U <br /> WORK OESCRIPTION • <br /> 'Dr� �"',q�.''"9 1�P� � 6�p�r�c� Re*af�►l.�Rep4PCEW�t�J� hrTti• `o1bJ�� un�l5 <br /> S�� Ir►a.� ir�t�or r+rw,c r�7.��«.�1. �ZcP,w.s <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI7CTURE OR ITEM <br /> Toilel A/C–air handling unlls <br /> Bathtiib Forced alr systems <br /> Lavalory(wash basin) _ Gas piping <br /> Slwwer Water heater <br /> _ Kitchen sink 8 disposal Gas fireplace � <br /> Dishwasher , Ges renge <br /> Clothes washer Cblhes dryer <br /> Waterheater Range hood <br /> Sink(aervicelbarlmop/etc.) _ Exhausl fan <br /> Backllow prevonter _ Heat pump <br /> Urinal Unit healer <br /> Ddnking Fountain _ Boller <br /> Floor dreln Refrigeration <br /> Grease trnp _ Woodslova <br /> Roo(drains Olher <br /> Olher _ — <br /> CITY 0(EVERETT LOCAL 8ALE8 TAX CODE 18 3106 <br /> I hereby coritily lhat I have read end exam�ned lhis application and kraw the same to be We and corted. All provisions of lawa and <br /> ordinaces goveming Ihle t��pe ol work wll�he complied wilh whether spec�ed herein or not.The granting ol a pertnll does not preaume <br /> lo givo authorily tn violate or cancol the provislon oi any other stalo or local law rogulaling construction or Ihe perlormance of <br /> ronstruction. That I n authorizod the wner ul lhis pmpoAy b perlorm Ihe work(or which epplicalion Is made and I comply with the <br /> Slate Contra tors 1827 RC .00 WAC. <br /> Sfg uro ol iorl ontr nzed Agnnl �t� (/Z <br /> l <br /> L----- -- — --- —- <br />