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RPR-12-2005 10:51 FROM: 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-BB57 <br /> SITE ADDRESS PARCEL TAX I.D.M PERMIT N <br /> 3 N�,�-9�,,. �, oo�s'�F��a2.�oo mo5o�-oic� <br /> LEGA LOT NO. BLOCK TR1CT <br /> DESC. <br /> OW R �onaesa ME �f— <br /> T�ar�i q M o//o y 3 yl o Jll a,-�. �¢vc �'d�� f�P�l Z 3�'t-!�3d <br /> TENANT'NAME CONTACT FOR PERMR PNONE <br /> I ,(.�nd� yLs � zo 3�P <br /> C��TcO� ��� (�n��� ADDIIE88 21P CON7R.LICENfEN <br /> PNO�E_ . ��i '7aj w w � �'�/�� �!t w ii�f�I�'✓! i�(� <br /> GO(O <br /> PROPOSED USE OF BVILDINO BulWing M8ch8nlCel Additbn HEAT SOURCr <br /> �� PERMR B Combinatlon Pambinp WORK R Ntxatlon I � ENcttc <br /> TYPE D Demolilion S n T'PE D New Gaa <br /> D Sprinkler D aec�i�n�n.�,�. ome� <br /> CONiRACT PRICE OF WORK / _�� _ CITV OF EVERETT LOCAL SALEB TAl(CODE IS J10S <br /> l.(L <br /> WORK DE9CRMTON <br /> G� 7a C'-y4� �cJ�-� �-[�� �.v� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF Fl%TURE OR REM NO., TYPE OF FD(TURE OR ITEM <br /> WATER CLOSEf(TOILEn A/C—AIHANDLING UNITS <br /> BATHTUB FOr�CED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEA'�PUMP <br /> _ SHOWER UNIT HEATERS <br /> KITCHEN SINK S DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANOE HOOD <br /> LAUNORY TRAY � WATER HEATER <br /> CIOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPIACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFIOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOPlETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I MEREBY CERITIPY TW1T I HAVE READ AND EXAMINED TFi15 APPLICATON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS ANO ORIOINACES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIEO WITM WMETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOUTE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TMAT I AM AUTHORIZED BY THE, <br /> OWNER OF TMIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONT CTORS IA .27 RCW AND 298.20 <br /> � �� `� rz Qs <br /> S a re Owner Conlracbr� e Agent ate <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />