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aFR-16-2007 11: 10 FROM:PERIIIT 4257756315 TC�1425257B857 P.1 <br /> � <br /> PERMIT /�PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SI7E ADDRESS PARCEL 7AX I.D.ii PERM�a � /, <br /> z4 �r /�ve zQ�s �oaa o /�d %� i�' J <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PI10NE <br /> '�''�`f�lJ��tJ`f��-N2'GI �!9 Ever���'-e �BZo'S �ZJ"2�/.JCa/� <br /> TENANT NAME CONTACTFORPERMIT PNONE <br /> `�"D �T��'�-�C I /L1�2 C��- y2S 27rj - S ��� <br /> CO�pe��w^�� ��� ` ��� ADDRESS ZIP CONTR.LICENSE# <br /> W T ��,//� C�E�vES'FK37P1�10 <br /> PHONE - ����O S• C��L�-ee�CYc`�u- �F�II 0 <br /> zoC� 7z2 /S�S- <br /> PROPOS[D USE OF 6UILDING Build(ng �Mechanical AddlUon HEAT SOURCE <br /> PERMIT R�-( Combinalion Plumbing WORK Alleretion ElecUic <br /> A trl.in� , I IYPe �-( Demolilion Sic�n 7YPE IJew Gas . <br /> ��V/r� V Sprinkler �RepalNMainl. �Olher(>/� <br /> CONTRACT PRICE OF WORK �^it/_ � /�n CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> �'4'UCQ V L� <br /> WORK DESCRIPTION <br /> �( � �/'YIQ..ce /�Q��l4'I�� 7Y2z/L� 7`�F�rtc v6 7' <br /> (OO�Ooa �'v�! <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEA1 NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNI�S <br /> BATHTUB � FORCED AIR SYSTEtiI� <br /> LA�ATORY(WASH BASIN) HEAT PUA1P <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUN�RY TRAY WATER HEATER <br /> CLOTHES WASHER fvIETAL FIREPLACE/S70VE <br /> ^ URINAL FIREPLACE INSERT <br /> � DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS ftANG[ <br /> BACKFLOIN PRE'JENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER � OTHER_ <br /> 1 HEREBY CERITIFY THAT I HAVE READ AN�E?(AM111NcD THIS APPLICATION AND KNOW THE SAAtE TO�E TRUE ANO CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS Tl'PE OF N'ORK WILL BE COh1PLIED WITH WHETHcR SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERAIIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4Tc OR CANCEL THE PROVISION OF ANY OTHEH <br /> STATE OR LOCAL lA6Y REGULATItJG CONSTRUCTION OR THE PERFORMANCE OF CONSTRl1CTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM 7HE�VORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT CTORS LA .27 RCW AND 2P6.200 ' <br /> l/6t�o_ i� � � � (7 D <br /> Si al re of OwnedConlractor/A i rized Ayenl Date <br /> DE81T & CREDIT CARDS ARE NOT ACCEPl'ED <br />