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JUL-21-2�04 10:z4 FROM: „� Ta 14252578857 P.1 <br />SITE ADDRESS <br />zl1 � C <br />LEGA� lOT NO. <br />DESC. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETI", WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. # <br />O'� .%� S� D C�� aG /� o C� o0 <br />BLdCK 7RACT <br />i%n S C-�-eh-�- �e� <br />T£NANT NAME <br />- s'��-� <br />C�J� �Y l �` / ( <br />PHONE <br />�o� 2�a- �� <br /># �-} , <br />-1 Vi 1 -�� � <br />ADDRESS ZIP PHONE Z�_ <br />�[�� (�a� s� .1� �v�r�l.� q�zQ3 3 �-�� <br />.� <br />2�� <br />CONTACT FOR PERMR PHONE <br />Lt�d� ��l ����� �2�7�032� <br />ADDRESS (� �. � j�_ <br />o�.� ���„e <br />� <br />M� Z1P CONTR. LICENSE # <br />� ��1�� <br />- � ��-f�rEs��, <br />PROPOSED U5E OF BUILDING Building Mechanical Addltion HE T oURCE <br />PERMIT Combination Plumbing WORK Alteration Electric <br />S/""� 1'1fPE Demolition Sign TYPE New Gas <br />� Sprinkler RepairlMaint. Other <br />CONTRACT PRICf OF WORK %„/�'� �" CITY OF EVERE7T LOCAL SALES TAX CODE iS 3105 <br />(�ty � <br />WORK DESCRIPTION ^ <br />� �. ��-� � ' k� ��c� f ��� pt� <br />c� � 3 ��x � �`� 2 -� � <br />N0. <br />UMBING <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN} <br />SHOWER <br />KITCHEN SINK 8� DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SlNK (SERVlCE/BARlMOP/ETC.) <br />OTHER <br />M <br />N�. I TYPE OF FfX'fURE OR ITEM <br />A/C-AlHANDLING UNITS <br />FORCED AIR SYSTEMS <br />� HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HO00 <br />WATER HEATER <br />METAL FIREP3.ACEiSTOVE <br />FIREPLACE lNSERT <br />GAS FIREPLACE <br />GAS RANG� <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT ! FiAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF lAWS ANO ORIDINACES GOVERNING 7FiIS TYPE OF WORfC WILL BE COMPLIED WITH WHETFfER SPECIFIED HEREIN OR <br />NOT, THE GRANTING OF A PEi2MIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE dF GONSTRUGTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TFiE S�ATE <br />CONT �O� �` 1.27 RCW AND� AC. l�-Z.l �- / <br />( <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />