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. ,` _u ' e-•. =i�.. <br /> , .... . _ . .. � . . <br /> k � . �ti � i �.' ..?� kes...� ^. +..� �t p. f s t: � i <br />'T� . ��1� ��: .. . . <br /> � , € F('QS..�..`. �, a....C7:. � te <br /> - : R f �i'. •?r xt t�`,� i'7"r'.¢ .-� ` f.,:., r�`�� ...i s _ . <br /> � �. � ..�i'.. . . � � � _ � �. tc }�,< <�\` F�, .,^_ _ ... _.,. `;� <br /> � <br /> I - p(�RMII' p►�PLOCA`TIO�1 `tc,�lGX.c <br /> CITY OF EVERETT �ERPJlIT SERVICES ' <br /> 320C CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org <br /> I APPLICAI'IONS ARE ACCEPTED FROM 8 AM TO 4 PM L 7D� ��Q� <br /> SiTE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> I "7 o t �- l l , i �>� �.�.�--' /I1 -4- <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AODRESS CINIZIP PHONE , <br /> C� -ti o�. �,�r��_n F,nt:;.t;� �o . 4c�i z ����Y ��a -��;�3 EvC-rearr�✓�+ yas-as�-t��zz i <br /> TENANT NAME CONTACT FOR PERMIT PHONE I <br /> vr AN.Y Not�t�nAr1 � �onnC s+tA��( �z s -(�02- 2sag <br /> CONTRACTOR ADDRESS CITYIZIP PHONE <br /> M�=r��i nn�:LNnn.l� ra.� q�v'�o i53sJ ;\�14 �IE� R�GtsD�J,�,�lA �tE�oSZ, i <br /> CONTR.LICENSE# <br /> Mc-Tc�`r hrS 1103 L v✓i �f 25- B�'33 -�IZ2.�I <br /> USE OF BUILDIfJG HEAT SOURCE CONTRACT PRICE OF WORK <br /> �xiSTINC� ,� IZ �'10� , 0 � <br /> C�-p���� �__ (' �� � ( � X Electric _Gas_Olher 1 I <br /> WORK DE5CRIPTION �� -7 G�t-i til G �X H-AVST F� S ', <br /> I I-��Pt-1�C.t� � Tt-fcYZMO5T7k"� <br /> C�c�_nr_��-i�' =Xis�n(c� R�r`Rlc�-�-�no�J t iP� �JG I <br /> (�r.. � -n�,���3- �-rrsr, nl � s� PP�� �cN�J R �s��z-' �' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM ��i <br /> Toilet _ A/C—air handling unils <br /> BafhWb � Forced air syslems � <br /> Lavalory(wash basin) Gaa piping <br /> Shower Water heater <br /> k"ichen sink&disposal Gas fireplace <br /> _ :.�shwasSier Gas range <br /> Clothes washer = Clothes dryer <br /> Laundry lray Range hood i <br /> _ Sink (service/bar/mop/elcJ �_ Exhaust fan I <br /> Backflow preventer Heat pump <br /> _ Urinal Unit heater ' <br /> Drinking Fountain Eoiler I <br /> _ Floor drain Refrigeration ii <br /> Grease trap Woodstove <br /> Roofdrains S OtherTNe'Rt.nOS�F�S <br /> — other 5 RcF2, -,�RR"Tio� PiPnfV REs��4%e� I <br /> I'7 ���T ', lSio� � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS;105 <br /> I hereby ceritify that I have read and examined this applicalion and know the same to ba lrue and correcL All provisions of laws and � <br /> ordinaces goveming this typa of work will be complied with whether specifed herein or nol The granting of a permit does not presume �I <br /> to give aulhority to violate or cancel ihe provision of any other state or local law regulating construclion or the peAormance ot I <br /> construction.Thal I am authorized by the wner of this property lo perform the work for which applicalion is made and I comply wilh the I <br /> State Contjactors Law 1827 RCW arjd 200 WAC. <br /> �� i. ..Ni- �_� G� -i �' =-,� -z(c -O�] I <br /> Ignature of OwnedContractor/Au onze Agent Date <br /> I - - - ----- — -- _ _ _ .; <br /> -- �.. _.. �=;t:-�-- : ..— �rr �..:.---�ss.r�r•r— ur�:. .r�.- <br /> .- . I � ` � _ . . . . . . � <br />