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Sent By: HP LaserJet 3100; 4258249516; Dec-2�-:� 0:32Afd; Page 3/3 <br /> PERMIT APPLICATION —� <br /> c��� CITY OF EVERETT PERM17 SERVICES <br /> z� <br /> 3200 CEDAR STREET, EVERET7, WA 9820 i, 425-257-8810 �z`� ` �5 <br /> SITE AODRESSi PARCEL TAX�•�•K PERMITA� <br />, 1727COLL�YAVC+.EVL'RETI',WA 9620� UD4380347014U0 Mb5 _ 6�� <br /> LEGAL LCIT NO. BLOCK TRACT <br /> DE pHONE <br /> OWNER ADDRESS <br /> 1727 COLBY AVE (425 i252•4y%� <br /> \vt'ATI',JU • EVGRETI',NA 98201 <br /> TENANTNAME CONTACTNAME PHONE <br /> PAMEI.A IlII l. 4'_5 81�-3123�1.3 <br /> CONTRACTOR ADDRESS C�NTR.LICENS�IF <br /> pASTWA�C�RHI:ATLRCntii1'ANY 12l01132NllAVENE PpSTRf1CO5:f�F <br /> KIRKLANU,WA 980?.l 02�16:OQ? <br /> PHOl1E (425)814-312d <br /> Buildinp ��tA�ch�nta Adellion M 7 SOURCE <br /> PROPOSED US�E OF BUILDING PERMIT Combinatlon LJ"lumbinp WORK �yuratlon �ecirlc <br /> D�molWon �I n 7YPE +raw u <br /> TYPE �' e R� drlMatal ner <br /> CONTRACT PiiICE OF WORK 5449.00 CITY OF EYERETT LOCAL SAlE3 TAX COP�iS 3705 <br /> WORKDESGRIP"IDN ganurc/RcplaceGnsR�a�crlleatcr <br /> MECHANICAL <br /> pkUM9lHfi � E OF FD TU E NO TYPF F FIXT R ITEM <br /> N . p�pq�NqNOLING UNITS <br /> ___ riATER CLOSET —�-- FORCED AIR SY57EMS <br /> B 4TMTUB —r HEAT PUMP <br /> _, LIVATORY(WASH BAS:N) —"'-" UNIT HEATERS <br /> _ 4HOWER '-- CLOTHES DRYER <br /> +� KITCHEN SINK 6 UISP09AL � RqNGE HOOD <br /> � DISHWASHER '"-j- WATER HEATER <br /> � LAUNDRY TRAV —�-� METAL FIREPLACEISTOVE <br /> CLOTHE9 WASHER �— FIREPI.ACE INSERT <br /> � URINAL --�� GAS FIREPL4CE <br /> 'J ORINKING FOUNTAIN --' �pg RpNGE <br /> � r F,LOOR ORNN GAS PIPING <br /> 9ACKFLOW PREVENTER " p�(HAUS7 FAN <br /> � SINK (SERVIGElBARJMOPlETC.) --- OTHER�__�__�_.------- <br /> ---- CTHER---- _ ------ --�"" — <br /> ---- --�'_-------'----" _�, �'--_—_----'_�----'- <br /> 1 nEREBY CERTIfY Tt+AT I HAVE READ AND E%AMiNEo THIS APUCAnON �ND KNOW Tii6 SAME 70 BE T�tUE AND CORRFCT.A�: <br /> OR NOT.TNE- GRI NTiNG OF A EIRM TCDO 5 NOT PR$UME O ONE AV,HORITY TO VCO ATE OR CANCEL THE PROVIS ON OF ANY ' <br /> BYHN[OW ERF�F TH 5 ROPERTY O P RFOftMTTHE WORK OR WNEaHAPPi.ICA110N SpMAOF ANO COMPIY WIMM THE STA E� <br />�F CON7RACTOKS'.AW/8.27 RCW AND 296.200 WAC. <br /> �ale 12/2:12005 <br /> Slynalu�votOMnoNGontncrotlAuthari:�dApem ���=;,:,�- „_�y�r�c .�' <br /> ui�r. <br />