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MAR-16-2005 08:27 PM DAVE.BEAMES <br />N <br />� SITE <br />425 259 2980 P.dl <br />�ERMIT APPLICATION 3 _ a�_o5� <br />CITY OF EVERrTI' PERMIT SERVICES p�03 -�� , <br />3200 CEDAR STREET, EVERETT, WA 98201 ; <br />425-257•8810 — FAX 425-257-8857 — w�vw.everettwa.crg ; <br />APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />LEGALI LOTNO. <br />DESC. � <br />WNE3– R -- <br />; :�a � <br />' TENANTNAAIE <br />PARCEL TAX I,D, it <br />u�� � <br />I e�ocK ra�cr <br />G <br />) <br />FOR <br />PERMIT# � I <br />/-� s v �j- <br />� <br />PHDNE <br />�.�C ,�' - .� � <br />� ,._ � :, � �_ ._ ; <br />PHONE <br />I � � <br />: � <br />I CONTRACTOR � �� MDRESS C�TY21P PHONE <br />'(?f fC'> iG::�'ll��. � �'/CC6U3/L��� // ��/['-[' �l f'�i�ti/ (i!' '7^ ✓ <br />� 3Y �.�c:-,�i?7 ,� > >'- 1 1 '� <br />( CONTR. LICENSE N <br />t:?� 7L.:G� �$ i' i��n':)� ...i /_� <br />115E OF BUILDING <br />WORK DESCRIPTION <br />N0. I TYPE OF FI%TURE OR ITEM <br />Teilet <br />� BathtuD <br />. Lavatory (wech besln) <br />� Shower <br />! � Kitcnen eink 3 disposel <br />Dlshwaeher <br />� � Clothes vrasher <br />Laundry trey <br />� S;nk (6ervlCe/har/mop/elc.) <br />� 9ackBow praventar <br />_I Unnal <br />i `' Crinkin6 fowtain <br />Floor draln <br />Grease trap <br />I Roo' drain� <br />Other <br />HEATSOURCE <br />Flectnc Gas Olher <br />CONTFtACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />_I A/C – air hanCllnp units <br />Forted air sysiams <br />T� Gas piping <br />_I Walarheeter <br />_� Gas fireplaca <br />� Gns range <br />Clothea dryer <br />Range hood <br />Exhaust fan <br />Neet pump <br />� Unll healer <br />—I Boiler <br />—I Rehiperaticn <br />Woodetove <br />� Other <br />CI7Y OF EVERETT LOCAL �ALE51'AX GOOE IS 7'105 <br />� <br />I <br />I hereoy cariuiy ;hat I have read anC exam;ned th:s applic�licn actl know lha same to oe true and ;.ovect. All provisions of laws and �, <br />orCinaces 6oveming thie ype of �.vork will b0 cJmpGec wilh whetner Specified herein or no:. The grentinp of a permll does not prBSurt19 . <br />�o gva euthonty lo vi0181B 0� CBn�CI th0 provi5i0.� Of Ony Other sta�e 0� �ocai law regulating construcUor. or tha Do�'ormanoe e' <br />const�ucl!on. That I am autr,,;nztd by lhe owne� of thln property :o Fertorm lte werk `cr wh�,th BFVIICatIOn I� made and I Comply •xith Ihe � <br />S:ate ContreFtors uw ' B2; RGri and 246.20C �VAC. I <br />. <br />' �.' • � . �i.� ✓�'''t�� ; �..�1.._.._:.�� �, <br />. .. ' c.0 �i. i <br />