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faPR-25-2005 10:39 �ROM: T0:14252578857 P.1 <br /> � � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D./ PERMIT M <br /> I S �arK� �Y Uo3y ce�9c� Nw���ti -� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> AOD S ��� ZIP P O E <br /> hl7c� ��2r l y�S f�a� DY w� 4�Z�� Yz1' 35'3 �$� � <br /> TENANTNAME CONTACT FOR PERMIT PHONE <br /> S��'�'-2. I �-l�2d�. yis 7 70 32� <br /> ���pp�7�� ��� (�n^�`n f ADDRESS ZIP CONTft.LICENSE M <br /> Ru �r v r c�y�� �J� � <br /> PH E � //L VYl k� "WL�N /a' C�J�4l'/rit,l9�i c�q <br /> � z-SZ 7�v ,t,� r <br /> PROPOSEDUSEOFBUILDING BUllding yV MeGhanipl I AAdltlon I HEATSWRCE <br /> PERMIT R Cambinatfon`� PIum6(ng WORK R Alteraum �Electrie <br /> TYPE D Demolitlon D Slgn 7vPe D New Gas <br /> U SpdnWer D ReOaIrlMainL OtAer <br /> CONTRACT PRICE OF WORK ��i � CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> WORKDESCNI�� r � � r �� /;,�4 /�__ �- L-,.n <br /> �i� � <br /> ��d(L 'fra- C..� E� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ AIC—AIHANDLING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> + LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOiHES DRYER <br /> DISHWASHER RANGE HOOD <br /> IAUNDRYTRAY � WATERHEATER <br /> CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE INSERT <br /> ORINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOPIETC.) _ EXHAUSTFAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVIS�ONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK W�LL BE COMPLIED W ITH WHETHER SPECIPIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE, <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IC MADE AND I COMPLY WITH THE STATE <br /> CONT CTORS lA .27 RCW hND 29620p.�l �/2�/U� <br /> 4 (V ( � <br /> SI a re o Owned ntractor ed Agenl ete <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />