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DEC-11-2003(THU) 15:17 <br />P 001/003 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257•8810 — FAX a25•257-8857 — www.everettwa.org <br />APPLICAiIONS ARE ACCEPTED FROM 8 AM TO 4 PM , a-� a- d� <br />SITE ADORESS <br />505 l�'el 'D t'` <br />LEGA LOTNO. �LOCK <br />OESC. <br />OWNC-R <br />Ic�ama� ge,l�Q��'-, <br />TENANTNAME <br />PARC[L TN( I.D. # <br />TRACT <br />50 5 Lau.ne,l �J � <br />c�r��Hn�iun(7/ F•Ui t�R�lYI� �2, <br />GL <br />CONiH. LICENS[ # �EL REII�"i �U � O � <br />USE OF BUIL�ING <br />N=S1 � Fi-L <br />tt <br />CONTACT FOR P[R�diT <br />���� fla,rper <br />/\UUIICJJ <br />75•N� /2l�PL �G <br />HEATSOURCE <br />_ Etactric � Gas _ Other <br />f�'IO�iz- C� <br />2al 425 � Z59� l7/; <br />PHONE�� Q�g.•�.�� <br />a <br />GSo3g -- <br />�-Z,s- �i4.� 4�� <br />CONTRACT PRICE OF WORK <br />�350� � <br />WOfiK DESCRIATION <br />�6�GR-ce d� iu�'N� Rzl�( Earfh�cak� Ua-1 ve <br />PLUMBING <br />NPG OF FIXTl1RE OR :TEh7 <br />Toilet <br />Bathtub <br />Lavatary (wa,ti basin) <br />Shawcr <br />Kilchen 5ink 8 dl,posal <br />Di,hwasher <br />Clothes washor <br />Wator hoatar <br />Sink (sarvice/bar/mop/olc.) <br />Backflaw praventer <br />Urinal <br />Drinking FounWin <br />FloOr tlraln <br />Grease Irap <br />Rool draln, <br />plhCr <br />MECHANICAL <br />N0. I TYPE OF FIXTUR[ Op 17LM <br />NC — air hand!ing units <br />� Forcodairsyslems <br />, Gas pipinfl <br />_ Walor hoater <br />� Gas tiroplaco <br />Gas ranga <br />� Clolhas dryor <br />Range hood <br />_ Exhaust��� <br />fieat pump <br />Unit heater <br />6oller <br />� Flelriporation <br />W oodstovo <br />^ Other <br />CITY OF EVERETT LOCAL SALE-.S TWC COD[ IS 9105 <br />I hareby coritity �hat t havo read and examined this application and know �ho same to be true antl correcL All provisions af laws and <br />ordinacus govorning Ihis type of work will hC ccmplied with whc�ihor &pociliad horein or nol. The granllnp ot a permit dces nnt prosumo <br />to giva authority to violale or Cancel the provision o� any olhor stata or local law rCgulatinp Construcllon or the perlomiancu o( <br />conclruction. Th�t I am horized by Ihe owner at this proporry to purform the work lor which appllcatlon is mado and I compiy wllh Ih0 <br />SIatC G IraClors n� A2��7 /ftCW antl 29620� WAC. ry <br />��l� ' 1_l.YiC� /2 '��' � d <br />