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DEC-27-04 flON 03:48 Ph EVERETT PERnIT SERV]CES FAX N0, a25 257 A857 P. 03 <br /> I PERMIT APPLICATION <br /> CITY OF EVERFTT PERMIT S�RVICES <br /> 3200 CEDAR STREET. EVERETT, WA 98201 <br /> 425•?,57-8810— FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTE� FROM 8 AM 70 4 PM -DE81T 8 CREDIT CARDS ARE NOT ACCEPTEb <br /> 51Tt9ADOFESS S�1'Nlllu„. C�W�TL=IZ PARCEL7AXI.D.i1 PERMITf_ / <br /> �(;zs G���.;� c t-u��c-�-r c � �vl - ob <br /> LF.G4 LUTNO, RIPCK 7RACT <br /> ; q?5:.�.��_..._.._. <br /> UWkCR p00RESS r�J I H NE <br /> �� c'� ; u,w. C�t�r�vl,C �7�"l �ocKe�elJcr�4Ue �U�R�H (4�;) Z IZ�zz n <br /> IEN.��TNAMF. � �� CONTACTFORPCRMIT PI'ONE <br /> CiC�A�'_ lA ��i� I {::�v::,�. ��ob�?�o - 3061 <br /> f.ON�RAf,TOR� •~ r ADDRESS CITV2IP PHONE <br /> M��� S N6�N Z2i lopi- 5 5� ��e•-�1 <br /> 6 � -r 1 C�t-2-S)'�s o —as ��c� <br /> coHrR.uceN��n �,111;�5lJSp33 �1'_ <br /> Ua"F.UF 6UILCIING � � I HEA7 SOURCE CONTRACT PRICE OF WORK <br /> _,Eloctric _Gas Other � �S� �'— <br /> WOF2K�GSCHIHTION <br /> __— �-��1� s � �Y-- <br /> PLUIVIBING MECHANICAL <br /> FlO. iYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> __ 7oilet AIC—airhandlingunils <br /> _ Oaihn.ib � Forced air syslems <br /> Lavatory(wash�usin) � Gas piping <br /> ShoN�er Water healer <br /> F(Ilchrn sink 8 dispo+al Gas fireplace <br /> _ Dish�rchr.r � Gas range <br /> _ � Cluthos+vashcr Cloltiesdryer <br /> _ Laundry tr;�y Range hood <br /> _ Sink(servlcel6admOplclr,.) Exhaust fen <br /> __ Backtlu�v p�nvcntor r Heal pump <br /> _,_ � Urinal Unit heater <br /> .,, Drinking Fountain Doilor <br /> , _,_ floor drein RcingeraGan <br /> _ Gre�setmp Woods�ova <br /> Rd0(d�Ai05 �_ Olher <br /> Olher — '"—' <br /> II __.___._...__ _ <br /> � —•~y� CITY OF EI�ERET7 LOCAL SALES.TAX COdE IS 7105 <br /> �hcr,by[critAy th,.t I havo fead and oxOmlOed thi,�pplicatlan and know the same W be true and corred. All provisions ol laws and <br /> orA;nates gweming thi:rype ol work will ba complicd with whether specifed he�cin or not The pranling of n permit does nut preevme <br /> W qiv��i,thorily to vinl;,tn or cr�ncel Il�e pmvision ol any othcr slate or lotal law regulating construcLon or ihe perfo�manco oi <br /> , cnn^.�f�iction.Thzt 1 am authorizetl by the owner cf this proporty lo peAorm lhe work for which application Is matle and I comply wilh Ihe <br /> � 5t,;1r.fo/rtr�li!me Law 16.27 RCW and 29G.200 WAC. <br /> I (�'2r�' � �L--� --�-�, . <br /> � $i�jn;.t�m cf Uwncr/t, IraclorlA orize0 Agenl Date �/L <br /> I <br />