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=EP-29-2005 11�17 <br />FROM:PERI1IT � 4257756315 T�:i4252578857 <br />PERMIT APPLICAI'ION <br />CITY OF EVERETT PERMIT SERVICES <br />32Q0 CEDAR STREET, EVEkETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRE��I � �� f ! � <br />! <br />LOT NO. I OLOCK <br />�PARCEL TAX I.�. p <br />r(e 2000ao 3 ao <br />TRACT <br />W IiCH <br />1��� � P� Iv� a s G a/�efi4..J� S('] L�uC�yC i i�-- t��(� <br />��'G1 M.PJ <br />co��s� �l�Ll �/�%CQt,Ic <br />PHOZ-O�O �Z �'J /LL� !/f/'�� /� <br />PROPOSED USE OF BUILDING <br />I PERMIT <br />� ri�� �TYPE <br />�� �� <br />COMRAGTPRICEOFWORK --7llv <br />(l/ <br />VNORK OESCRIPTION <br />l <br />'ONTACT FOR PERMIT <br />,(-!/1Cz!� �zS '�,7� <br />ADDP.ESS <br />�orY, it� � i.�� <br />�� �w c <br />�Building Mechanical <br />Combinatlon � Plumbinp <br />Cemolition D Sign <br />Sprinkler <br />P.1 <br />�-�C-�'�) <br />PEFiM1T # Y <br />l zs—�t -fY. <br />ZIp � CONTR. UCEN:' e q <br />C�l9�!'yi�f/�/ c,� <br />Addltion HEATSOURCE <br />WORK Ateralion Q Eleclric <br />7YPE New U Gas <br />Repalr/Maint. U Olhor <br />GIN OF EVERETT LOCAL SALES TA7( CODE IS ]105 <br />�s W�-J�r h.2��/ �1�� <br />NO. I TYPE OF FUCTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 D�SPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PRFVENTER <br />SINK (SERVICEIBAR/MOPIETC.) <br />OTHER <br />NO. I TYPE aF FIX7URE OR ITEM <br />A/C - Ai' IhNDLING Um i s <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />� WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPIACE INSERT <br />GAS FIR�PLACE <br />GAS Ri+NG� <br />GAS PIPING <br />EXHAUST FP.N <br />OTHER . <br />I NEREBY CEftITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO 9E TRUE A�`J CORRECT. ALL <br />P40VISIONS OF LAWS AN� ORI�INnCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. TNE 61iANTING OF A PERh11T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br />O N EROOF THIS PR PERTV O PER OR 1 THE WORK FOR WHICH AFPL CAllO� IS A�tADE A DI I CObiPLY WITH THE SOTATE D BY THE <br />COt�T CTORS LA� 2,7 /RCW AND'296.29� � <br />�/i]i da �-i�7�ivv� ut / l l � �"� [ `�.� <br />DEBIT & �:REDIT CARDS ARE NOT ACCEPTED <br />