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12i12/2006 li:JB FAS <br />SITE A��RESS <br />LOT NO. <br />DESC, <br />PERMIT APRLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REET, EVEREfT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — wnww. everethra. org <br />APPLICA7lONS ARE ACCEPTED FROM E AM 70 4 PM <br />I PARCEL 7AX 1_O_ 8 <br />� ..CCC�192Vi�W CN'ir1�/�Sc' � <br />TctIANiNafAE ' <br />�Az, �z �.�, ,a.,� P� c� <br />CONTRACTOR <br />cONTR. LICENSE # <br />uSE OF BUILDING <br />/1c'-'17�i � <br />WORK DESCRIPPON <br />�7laYC �Kq�N9 �'v°c`J(�S�ES <br />J <br />7N� /,�a; loin-� 1✓� WLr2�t <br />NO. I TYPEOFFUC7UREORITEM <br />Bathtub <br />Lavatory (wash basin) <br />Showe� <br />Kiichen sink � dispocal <br />Dishwasher <br />Clomes washer <br />Laundry uay <br />Sink (servitelbarlmop/ctc.) <br />BaclAlow prev¢nter <br />Urinal <br />Onnldng founCain <br />Floor drain <br />Grease trap <br />otdrains ,� _ n ,�S <br />O�he� i�l,/�l-6i <br />TRACT <br />ADDRESS CIT/ZP <br />(6_a's` Cy� a�rl �✓� � <br />CONTlrCT FOR GLit1AT <br />�3d� oA:�r,,� v Ft� <br />ADDftESS CINZP <br />m uoi�ooa <br />T�RMIT# <br />���a-�`�( <br />PHONE <br />�o zoL-3z(-� <br />PF}OHE <br />�,>•� 9� a�3 <br />PHONE <br />HEAT sOURCC- ! cONTRACT PRICE o� WORK <br />____ Eleefic Gas Otlier I <br />r�r g�o'.� yF�r'oAow�+-y it� �'oi�Il/vs�w�y. <br />�,,� ,I�-i' g�,v ,�'�Io . ?-rac oF 8 {�jPl�s <br />NO. I 7YPE OF FlXTURL- oft REtA <br />NC — oif handling units <br />Faced aK rystetlt5 <br />Gas piping <br />Water heater <br />Gas fireplacc <br />Gas rangc <br />CloUics Crycf <br />Rangehood <br />Fxhausttan <br />Heat pump <br />Unit heater <br />Rafer <br />Rehigeration <br />Woodstove <br />Other <br />CITY OF EVEfiEiT IOCAL SALES TNC CODE IS �105 <br />! hereby cerrfify ihat� havetead and oXamined }his anp7ication end krrow ilie Sttn'�e fo be 6ue andcarcwt Ail pfovisions oflaws and <br />��.dnaCes govetning this qpe ot work will 6e complied wiN whether spacified herein o! noL The gfaating of a pertnil does not presume <br />to give authority to violate ur cancel the provision ot any other state or local law regula6ng conatn�cGon ar the pertormance oF <br />con5truction. Thai f:,m uu�horized by Uie ewner uf tliis property to partorm thu wn�k for wfiich oppficafion is made anJ I comply v+ith the <br />State Contrad�ore Law 1827 RCW and 2'36.200 WAC. � <br />, /; vY �.�,,._ 7 /2/f2{a 4� <br />��L <br />