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JAN-09-03 THU 02�24 PN <br />� <br />SITE ADDRESS <br />��C.�lcd <br />LEG� LOT N0. . <br />� RETT PERtlIT SERVICES FAX N0. 425 257 8B57 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMI7 SERVICES <br />32�G CEOAR STFiEET, EVERETT, WA 98201 <br />425•257•8810 — FAX 425•257-8857 <br />BLOCK I TRACT <br />PAHCEL TAX I.D.1 <br />PEflMiT R <br />rno 3v6 <br />� <br />OESC� I I <br />UWNER A�DHESS Z�P PM NE L.��"�1c�. �t.�C1 _ <br />���:. �-1,�� F� �� e-i-i � �A �14'.aC�� i���-} <br />TENANTNAME I CONTAC N�ME pHONE — <br />�o�r��TOA �1Y� �-�ec,.�,r�c� <br />PHUNE <br />PROPOSEO USE OK [IUILdN6 <br />COMRAC7 PHICC OF WORK <br />ADbRE55 <br />BWldinp !�Q Muchankal <br />PGPMIT R Combmatlon'�.j Plumbing <br />TYPE � Damolnian I_J Si9n <br />Sprinklcr <br />ZIP CONTR. LICEN3[ Y <br />c �i <br />14� �c .� r t1, �-�� ►� �� <br />r Addition HEAT SOURCE <br />�-Alter�lion I � Eloctdc <br />N.w Gat <br />RCWidM:iml. Orti�� <br />CITY OF fiVEqETT LOC11L 9AL[S TAM CODE IS 31os <br />WORKOESCRIPTION ,1�.�i�1111�1�(l n(�\�> t"IYC��C�C:� U"�`.�C'.{ i- �(L,\'111�Y1C����`� rl(�L. <br />:fi �;�(.,1�llC t' 1(-' C�Y � LC\,, . � � <br />N0. � TYPE OF fIXfURE OR ITEM <br />� <br />IiATlil'UD <br />�AVATORY (WA3H BASIN) <br />SHOWER <br />KITCII[N uIPJK b UISPOSAL <br />DISHWASI IER <br />LAUNDIiV TR�Y <br />CLOTN[.�iWASHER <br />UNINAL <br />DRINKINC FOUNTAIN <br />fL00H UftAIN <br />6ACKF�OW. PHCVENTER <br />SINK (SCRV�C[/DAfI/FAOP/ETC.) <br />OTHER�.____._ _ <br />N0. I TYPE OF FI%TUFE OR ITEM <br />A/C – MiANDLING UNITS <br />FORCEO AIR SYSTEMS <br />HEATPUMP <br />UN�T NEATEHS <br />CLOTHES DRYER <br />RANOE HOOD <br />WATER HEATER <br />METAI. FIREPIJICF/3TOVL <br />FIREPUICE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPIN6 <br />EXHAUSTFAN <br />OTHEH <br />' I NF.FFBV CEAITIFY THAT I ��AVE FC-AO AND .MAMINEDTMIS APPLICAT1lNJ AND KNOW TMG S�ME TO DE TRVE ANU GORFECT. ALL <br />PROvl610t7� OF 4/1W$ AN� OFlIDIrJnC65 60VERNING THIS TYPE OF WORK WIIL BECOMPUED WITH WNETMER SVECIFIED NEREIN OR <br />NO7. THC GRANTIN(3 OP A FCRMIT UOES NOT FRESUME T061VE �UTMOViITV 7D VIOLATE OR CANCEI THE PROVISION OFANV OTq[R <br />' S1A1E Ofi IOCAL LAW FEGUII�TING CONSTpUCT10N ON ihfE PERFOHMANCE OF CONSTRUCTION. THAT I AM AUTHORI2E0 BV TI1Q <br />• OI4NER OF TMIS Pf10PEh(V 70 PEqFORM TH[ WOfIN fOR NR11CH APPLICAT104 15 MADE AND I COMPLY WITN TME STATE <br />; CONTRACTOPSIAW 18.27 RCW AND236R00 WAC. <br />'-I <br />