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I� � <br /> PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425•257-8810—FAX 425-257-8857—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�1 PLI <br /> SITE ADDRESS PARCEL TAX I.D.� PERMIT II <br /> 112 IN(.�K • f-vE �Mf A�11 32o2�G� �fOA- �L � <br /> LEG LOT NO. BIOqC TRACT OR 6UBdNS10N� <br /> oesc. � 2(p Z'j <br /> R ADDRESS CITY ON � <br /> WIN�I/sYN T• `�Ly�RW Zll( IWG�tC M/� �Ilt�'CC�O1 42V��C$- 14� � <br /> 7ENANT NAME CONTACT FOR PERMR PHONE <br /> I�YTr L• 1'Vi�'�fiV/+� Ei1NL N/b• � <br /> CONiA.LICENSE 1 ���Cl� <br /> USE OF BUILDIN6 �m� HEAT SOURCE CONTRACT PRICE OF WORK <br /> m1�.�1���1� � �Electrb _Gas_Other 7'�Xf�Q�. � <br /> WORK DESCRIPTION <br /> 1y���R '�v�rr cmP��r�+n-r oF �crsrttaGc Wunxt-f+�+u•� DC�D <br /> �i ���-s cb�.a� +� 5 �"`^�� � <br /> f� • <br /> PLUMBING MECHANICAL <br /> N0. TYI'E OF FlXTURE OR REI+I N0. TYPE OF FlX7URE OH ITEM <br /> 6 Toilet _ AIC—afrhandlinpunils <br /> � Bethtub Forced alr syslems <br /> .� Lavalory(wash basin � Gas plpinp <br /> � Shower ✓ Waterheater <br /> Co KRchen sink 8 dis sal �/ �:' _ Gas Ilreplaco �hr <br /> �i Dfshwasher � �r' GES fdi1A8 �j/ \ (► ,�14 <br /> � Clothes wash V (, ✓ Clothes dryer /� `� � 1T� <br /> � Water heat � �u�\ ��.� ✓ Renge hood � � N�� � <br /> Sink(se ar/mop/otc.) Ezhaust fan �„ <br /> _ Backflo prevenl��r ��� Heat pum \l <br /> Urina T Unit he r <br /> _ Dri ng Founleln _ Boile <br /> FI r drai� _ Re Beratlon <br /> rease lrap _ slove <br /> oot drains her <br /> � O�her _ <br /> qTV OF EVERETT LOCAL SALES TA7C CODE IS 9105 <br /> I hereby cedtih�thal I have read and ezamined this apWication and know the same to be irue and correct. All praWslons d lews and <br /> ordi�aces goveming lhis type ol woiic will be compiied with whether apecNied herein or nol.The prantinp o1 a permlt doea not presune <br /> to give hority to violate or cancal lhe prov(sion oi any other slate a lacal law regulelinp conetrucdon w the performance oi <br /> const n.That I am authorizad by the cwmer of this property to perlorm the work for which applkallon is made and I comply with the <br /> Sl � tradors La 8.2 RCW and 296200 WAG �� � ?� <br /> gnature IOwnerlContrador/Authoriz enl ate �� <br />