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12/OS/2007 17:3� FAX 425 257 8857 EVERETT PERMIi SEF�VICES �002/003 <br /> ^' �� �y'�r�.�--�-'^"'1� � .m H.�'�.tri "^tQ"Z+a `'�.""t;'_,pi r ��"a'.'C'c� �'s.�;c:' � ti*x]S;'.+• ',a�ih��•. <br /> X-:a`_�3�:�'�.[n�.Vl.«�i�.� .M- TSr11'� .SL'hx l.�_ l.`'�'{W 'I�.1T ! 1�''.e;w�..���..n 'J�-:i�' -1. <br /> � �31 k.�. h��� � <br /> �� �.1'1�� "C`y '1: �T> A ..t 1"Y. SL r!'C� Zr - ���•'/�y;h.;.4�,^ s <br /> " � . � : . ;���E��R�1Fffi�;A#�P�'1C��I�iVY , . . . : . : _ . <br /> CI'fY OF EV�REI'T PER:MIT SERVICES <br /> 3200 CCDAR STREET, EVERETT, WA 98201 l Z `�3`� <br /> 425-257-8810— FAX 425-257-8f;57—www.everettwa.org 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Pid L �; -� ���?� � <br /> SffE ADDRESS PARCEL TNC I.D.# P�RMIT A <br /> 532` �:� �u�� � Ct�3�t 2cv�oo�ioc� I `� o�l'c�. - OU <br /> LEGA LOTNO.� � 0L ICK TRAC70RSUBDM310N# <br /> DESC. <br /> OWNER AD�RESS CiTY21P PHONE ;��_�.y�yy, j�_� <br /> 1 <br /> �a w� ►� 53 L� c-��,�,Y�.r�a� -ve�r�� (�.�n3 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE _,���.��j,y��.j L c� <br /> �q�n,'✓� t'Y�� S�L`�c�,1-� K i��L e�na� Sk�rk�J ��{'es�ci�.w• <br /> �6RTk7CC'�Ln— auo '� ci �— <br /> I -5 1�.5�J�� -i Ytilu����ctcl�l�c,_ �151 (rmm�c.e i=1 ..t�-. 3ic.�,.�tSY,�2�'�.� <br /> CONTR.LICENS�# � �.�G.SDM�t3y�P L�tcu,l � 1n'��1�5'J�lv <br /> USE OF'BUILDING HEAT SOURCE CONTf2ACT PRICE OF WORK <br /> C'D�m�,,,��ti'v�� I _Elaclric _Gas_Oth� r y� 3�� (pCJC� <br /> WORK DESCRIPTION <br /> ���si-G11 oh�. �illuv�;rw��-c� vku�� s�Jr�. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FU(TURE OR ITEM NO. 'fYPE OF FUfTURE OR I7EM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas p�ping <br /> Shower Water heater <br /> IGtchan slnk 8.disposal Ges fireplace <br /> Dishvrasher � Gas range <br /> Clothas washer Clothes dryer <br /> '� Water hezter Range hood <br /> Slnk(sarvicelbar/mopletc.) Fxhaust fan <br /> Back(low preventer Heat pump <br /> Urinat _ Uni[heater <br /> � Drinking Founfain _ Boiler <br /> Fbor drain Refrigeration <br /> Groase trep � Woodstove <br /> _ Rooi drains x Other .SiLi� <br /> ONer � <br /> CITY OF EVERETf LOCAL SALE3 TA](CODE IS 3105 <br /> I heroby ceritify thot I have read and examined thls application and know the some to be we and conect. All provlslons of laws and <br /> ordinaces goveming this type of work wlll ba compiied wilh whether speclfied herein or noL Tha grantlng of a permlt does not presume <br /> to give authority lo vlolate or cancel the provlslon of any other state or local law regulating construction or lhe peAortnance of <br /> consVuction.That i am aulhorized hy the owner o(this property to perform the work(orwhlch appliceUon Is made and I comply wilh the <br /> State Contraaors Law 18.27 RCW and 298.200 WAC, <br /> �' a )� !�.�� �� �albla7 <br /> Signature of OwnedContracloNAulhoriZed Agent � D te � <br /> lZ <br />