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GEC-1�-2�05 11:�5 FROM:PcRI9IT . 4257756315 T0:1425e576857 P.2 <br />i�ERMIT APPLIGATION <br />CITY Q� EVERETT PERMIT SERVlr�S <br />3200 CEDAR STREET, EVERETT, WA 9820t <br />425-257-8810 - FAX 425-257-8857 / <br />SITE ADORESS <br />LOT NO. <br />y�Yd <br />/ I V�i <br />BLOCK <br />TRACT <br />PARCEL TAX I.D. # <br />���/Ye �{�a�l/�h /�ooY�e �''3Z {�cP9f�t <br />TENANTNAME CONTAGiFORPERAI <br />�".�M�-�� ,(,r�rd� yzs <br />CO��TO� �,,,„ ^� (�n �.^ `n r ADDRESS <br />v rlX4� �'AV/ff=J /] � <br />PHONE !/✓ �7/ �OY7�1 �'Q �/'7�L �� <br />zOlo 7$L 7CU q� '�.c�r <br />PROPOSED USE OF BUILOING ('") Building I�MechanlCal <br />PERMIT �"�S Combina�ion Plumbing <br />^� NPE K Demolilion Sign <br />J Ll Sprinkler <br />CONTRACT PRICE OF WORK <br />_ZL- <br />PERMIT a <br />�00 )1-'1 = � _, _ <br />, �'fzo/ �?�?�SYiI3/� <br />PHONE <br />2�s Rys� <br />ZIP CONTR. LICENSE # <br />L�Cr/�J'f�/�.197/ � <br />99 <br />AddlUon I HEAiS011RCE <br />WORK � Alterallen D Eleclric <br />TYPE New ��� Gas <br />RepaldMa;nt t� Olhet <br />CIN OF EVERFTT LOCAL SALES TAX COOE IS 3105 <br />WORK DESCRIPTIO � �� ��� � z� �^�.L,� <br />J!///F[ <br />{�e�l �21��, <br />NO. I 7YPE OF FIXTURE OR I7EM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTR4Y <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR �RAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I NPE OF FIXTURE OR ITEM <br />PJC—AIHA�dDLiNG UNITS <br />FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIT HEAT��RS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEAi ER <br />METAL FIREPLACE/STOVE <br />FIREPLACE i�'SERT <br />GAS FIREPtACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAAIINE� THIS APPLICATION AND KNOW THE SAWE TO eE TRUE AND CORRECT. ALL <br />�'ROVi510NS OF LAWS AND ORIDINACES GOVERNING THIS N?E OF WORK WILL BE COMP! iEn ;y�71- yyHETHER SPECIFIED HEREIN OR <br />1�0T. THE GRANTING OF A PERMIT DOES NOT PfiESUME TO GIVE AUTHORIN TO VIOLhTE OR C:.I:CEL?HF PROVISIOIJ OF ANY OTHER <br />SfATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AGi AUTHORIZED BY THE <br />O'NNER OF THIS PROPERTV TO PERFORIA THE WORK POR WHICH APPUCATION IS MAOE AND i CO'.1P17 WiiH THE STATE <br />CONTR� CTORS LA 27 RCW AND 29'a.200 J <br />��" � �'%l ' <br />// !�/�.f li�o. OYYI tif�C. / L l `_ � �,� <br />DERIT & CRFI]IT CGRf1S laRE NOT ACCEPTED <br />