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MAR-21-2005 09:46 FR�1: T0:1425�"'S78657 P.3 <br /> � �— <br /> PERMIT APPLICATION <br /> CITY OF EVERET'T PERNiIT SERVICI�S <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE A�ORE55 /h��/ .n^ 7 <br /> PARCEL TAX I.D.il PERMIT <br /> � ���o �����.- W7 l4� �/UO V "\ > � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OW . AOORESS � � �L�_� ^_�� <br /> ��7�wr�n��r] �lo� �la1F J�t.� �'.U2� � `l�a / �szc�c� <br /> I CON7ACT FOR PERMIT PXONE <br /> TENAN f NAME l��T 7�a 3 2� <br /> . � �(t�� <br /> CONTHACTOR AOORESS CINRIP PHJNE <br /> wVts N �.t�i y �v r cos �I.ea�¢L� c�4 9��99 <br /> CONTR.LICENSE It rL�O� (�.Q ]�{ C� a(�(p 2��/w <br /> r . �r� r M�c.��r� l v8 u""`,�`,�� <br /> �' I HEAT 90URCE CONTRACT PRICE OF WORK <br /> USE OF BUILOING /� C/ <br /> �� � _Elec[ric �Gas_other �L/ 7 �7 ' �� <br /> WORKDESCRIPTION rn�L (/'� l �.���e (�p��CRJO Vf��s � ✓�"`�-' "�� <br /> �,k Ik i ��C.c <br /> �� .�r,�Pl�.ce --�t��.rf - �-Pl �'/ -�f ��Pi�j <br /> PLUM8ING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM <br /> NO. TYPE OF FIXTURE OR ITEM <br /> A/C-alr handlln8 units <br /> = Toilet � Farced alr systems <br /> Bathtub Gas piping <br /> Lavatory(wash basin) Waterheater <br /> Shower Gas Flreplace <br /> _ Kilchen sink&disposal Gas range <br /> _ Dishwasher -- Clothes dryer <br /> _ Clotheswasher �— Rangehood <br /> Laundry tray — Exhaustfan <br /> Sink(servicelbar/map/etc.) — Heat pump <br /> � BacMIoK•preventer � Unit heater <br /> _ Urinal — Boiler <br /> Drinking Founlain — Retrigeralion <br /> �loardrain — Woodstove <br /> Grease trap — Other <br /> Roof drains — <br /> Other � <br /> CITY OF EVERETT LOCAL SAlES 7AX CODE IS 7105 <br /> I hereby ceritify that I have read and examined thfs appllcatlon and k�ow the same to be Uue and correct. All provisians of laws and <br /> ordinaces goveming lhis type of work will be complled wNh whothor specified herein or not.The 9ranting of e permit daes nol presume <br /> to give authoriry to vlolate ar cancel the provislon of any other.tate or local law regulatlng conslrucUon or tha performanca ol <br /> construction.That 1 am aulhorized by the owner ot Ihis property to perform 1he vrork for which applicaUon Is made and i camply with lhe <br /> Stale C nU�La�CW and 29 .200 WAC. 3 `� �� <br /> L � <br /> SI atu o OwnedContractorlAu nze Agent ate <br />