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RW-30-200�i 11:01 FROM: T0:14252578857 P.1 <br /> PERMIT APPLICATIO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> � SITE ADORE S oARCEL TAX I.D.N PERMIT X <br /> �910 l3�u�k�a'�Sf( 2 pS3 /003o��/GC� EoKo&-�3 <br /> LEG LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRES9 LP VHONE <br /> L�O[..�[� S�YL ffh �{`1l0 �/eck jTw�[1�`( `1�203 �21"2� 7�C! <br /> TfNANT NAYE CONTACT FOR PERMIT PHONE <br /> ( � � ��� �QU� � �ZS7?03� <br /> ��,J'�5� ��� � ADDRESS ^ /_, e ZIP CONTR.LICENSE• <br /> r� 11�e�.y�f-t� <br /> PHONH �a�f"zw `zd'4s`��:t � 4�Q9 � �H�EJy�I a3 <br /> PROV0.SEOUSEOFBUILOING I 8uilding Mechanical Additlon HEATSWRCE <br /> PERMIT B Combination Plumbirg WORK B Alteratbn �Ekchic <br /> 7YPE D OemoNdon Sign TYPE Q New Gas <br /> U SprinklBf U RepalrlMalnt. ONar <br /> CONTRACT PRICE OF WORK (tC�Z,C�r� � CITY OF EVERETT LOCAL SALES TA7C CODE IS N�DS <br /> L <br /> WORK DESGRIPiION <br /> CJUJ 7� 94s �vrnQ�e c�t4 �r�- <br /> �, c�rc.> !� `S <br /> PLUMBING MECHANICAL <br /> NO. TYGE OF FIX7URE OR REM NO., TVPE OF FI%TURE OR ITEN <br /> WATER CLOSEf(TOILET) A/C—AIHANDLINO UNIT3 <br /> BA7HTU8 Z FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> OISHWASHER RANGE HOOD <br /> LAUN�RYTRAY WATER HEATER <br /> CIOTHES WASHER METAL FIREPtACEISTOVE <br /> URINAL FIREPIACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BARJMOPIETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFV THAT I HAVE REAO AND EXAMINED TMIS APQLICATION AND KNOW TME SAME TO BE TRUE AND CORRECT. AlL <br /> PROVISIONS Of LAWS AND ORIDINACES GOVERNING TMIS NPE OF WORK WILL BE COMP�IEO WITM WHETHER SPECIFIEO HEREIN OR <br /> NOT. TME GRANTINO OF A PERMIT pOES NOT PtiESUME TO G�VE AUTHORITV TO VIOlA7E OR CANCEL TNE PROVISION OF ANV OTNER <br /> STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR TNE PERFORMANCE OF CONSTRUCTION. TMAT I AM AUTHORIZED BY THE <br /> OWNER OF TI115 PROPERN 10 PERFORM TME WORK fOR WMICM APPLICATION IS MAOE ANQ I GOMPLY WITN TlIE STATE <br /> CONT TORS LAW 27 RCW ANO 2% 0 WAC. _ / G <br /> �%�4 'n "�'��� �� 7?O 3�d <br /> Sg W o Owner/Conhacmr/A rizeA ent te <br /> DEBIT&CREDIT GARDS ARE NOT ACCEPTED <br />