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0 <br /> DEC-17-01 10:2Y FROIMNORTNWEST- SIWIR 206-3T4-0834 � T-o61 P.01/02 f-2o7 ' <br /> PERMIT APPLICATIO�V <br /> C:ITY OF EVERETT PERMIT SERVICES ' <br /> 32�0 CEDAR STREET, EVERETT� WA 90201, 425-257-8810 <br /> PARCE�TAX 1.0.N PERMIT N <br /> SRE ADDRE�S m0!1 o`Z-0 IS <br /> L�ydb ��y,� s•}vt�.i 290 `l36 ouW G12u0 <br /> LEGAL LOT NO. BLOCK TRACT <br /> OESC. <br /> OWNER I ADORESS � PHONE y� S i <br /> '1 �140 6 £.��^^ r� . ds2 - 95r1 <br /> Ua.i�t� S�ti�^Q�f ,_ � � PHONE <br /> TEn.oNT NAME I CONTACT NAME � 1 a b • <br /> � '� �.a.'n�iCe Fi�l��1��V 1 �P1 ' �/� OJ <br /> CONTRAt:TOR <br /> ' ADDRE55 � CONTR.I.IClNSE N <br /> ca e, Se� � fvv -tl�ur+��y � �d0 c:�Asl�k'•SS'9Ac� <br /> PHONF. �`6 - Jd�- �I� v0 str� 9F� F5 <br /> I PQQPOSED USE OF DUILDINi3 Building M�hanieal Atldi�ian HEAT SO�U�RCE <br /> pERMR Combinatfon � Plumbing WORK � 1Uterntiwi G� <br /> TYP6 Demolitian U Sig� TMPE q�z�dMeint � ���1er � <br /> S'r R Sprinkler <br /> CONTRAC7 PRIC6 OF WORK �' � S p O CITY OF EVERETf LOCAL SALES TAX CODE 13�1�5 <br /> � <br /> WORK DESCRIPT�ON <br /> (�1 - inr3 `�1� o..•a GS� OJI OKN y �t r..�-.c.p wJ P+P�^5 <br /> �t��'�� ..r� Svr ����j <br /> ;��J ' '^s�-+JI �.,c ,�tr w•�" • <br /> MFGHANI�AL <br /> p�. M�1NG <br /> N0. TYPE OF FlXT.IAE OR ITEM N0. TYPE OF FlXTUqE Op ITEM <br /> _, WATER CLOSET A1C-AlHANDIING UNITS <br /> BATHTUB .�. FORCED AIR SYSTEMS <br /> , IAVA70RY(WASH BA$IN) � HEAT PUMP <br /> UNIT HFATERS <br /> SHOWER ; CLOTHES DRYER <br /> � KITCHEN SINK 8 DISPOSAL qqNGE HOOD <br /> ` DISHWASHER � yyATER HEATER <br /> � WUNDPYTRAY � METALFIREP�CE/S70VE <br /> � CLOTHES WASHER FIRE?LACE INSERT <br /> , URINAL � GAS FIREPLACE <br /> � DfiINKING FOUNTAIN � �,AS RANGE <br /> � FLOOR DFlAIN 2 GAS PIPING <br /> BACKFLOW PREVEPIiER u EXHAUST FAN <br /> � SINK(SERVICEl9AR/��OPlETC.) OTHER <br /> — OTFIER ' _ I <br /> I HEREBY CERITIFY THAT I HA\'E READ AND EXAMINED THIS APPLICA710N AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL <br /> pROwSiONS OF LAWS ANO OFIDINACES GOVEfiNING 7HIS TYPE OF WC:'K WILL 9E COMPLIED WRH WFIETHER SPECIFIED HEREIN OR <br /> NOT. TME GRANTING OF A PEIaMIT DOES NOT PRESUME TO GIVE AUTNORITY TO ViOL1TE OR CANCEL THE PROVISION OF ANY OTNER <br /> STATE OF�LOCnL LAW REGUL�TING CONSTRUCTON Oq THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED gY Ti'iE i <br /> OWNER OP THIS PROPERTY Ti�PERFORM 7HE WORK FOR NMICH APPLICATION IS MADE AND 1 COMPLY WITM THE S7ATE <br /> CONTPAGTORS LAW t827 RC�N ANO 2?6.200 WAC. <br /> ____�_f� O<e i •� <br /> Si re ot OwneuContractadAuthon �gent ate <br />