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JUL-8-2005 15:14 FROM: T0: 1425?578857 P.3 <br /> —� 3 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBfT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADORESS PARCEI TAX 1.0.N PERMIT 11 � <br /> l`-�(D Duk�,1'�, cx��Sv (02 Da��o 'r �� v <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER A DRE55 CIT721P PHONE L�_ <br /> �Gni(A �-lcaban I y�o �Ir.¢.r�Qve. ��t.�/� 16'zo� 339 zi�i / <br /> TENANT HAMIE I CONTACT FOR PERMR PHOHE <br /> S�i lyt� Lrv�cl4 4Zs 7�o �z�� <br /> CONTRACTOR/ ,�WfH �//�// �J(,� _`p�RES$ CIT`.'P_IP PHONE <br /> W I N '^�I � v--" rJ p� W11G� �CJ� �d"Y /� <br /> �A�U �-.�1'�/�r <br /> CON(Ft.UCENSE t ///f1 f�.f/'=�('��l^Q <br /> vvi J J (G� ..�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> (�� _Elactric x Gas_Other �Qv� ^ <br /> �l <br /> WORK DESCRIPTION <br /> 9�1 �, 9� GJ�� hc�-�- ch��� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE ORlTEM <br /> Toilet _ AIC-airhandlingunits <br /> Bathtub _ Forced air systems <br /> Lavatory(wash basin) Gas plping <br /> Shower � Walerhealer <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clolhes washer _ qothes drycr <br /> Launtlry Uay _ Range hood <br /> Sink(servicelbar/mooletc.) _ Ezhauslfan <br /> Backflow preventer _ lieal pump <br /> Urinat _ Unil heater <br /> _ Orinking Fountaln _ Boiler <br /> Floordrain _ Retrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other — <br /> CITY OF EVERETT LOCAL BALES!AX CODE IS 3705 <br /> I hereby ceritify that I have read and examined thl>applicatlon and know lhe same to be true and coi�ect. All provisions of laws and <br /> ordinaces goveming lhis rype of work will be complletl with whether specified heretn or not.7he granUng of a pertnit tloes not presume <br /> to give authority to violato or cancel the provision of eny other slale or local law re9uiating conswction or lhe peAortnance ot <br /> wnslructlon.That I am aulhor¢ed by the owner of this property to perlorm lhe worte for which applicalion Is made and I comply with ihc <br /> Stnte C traclora L�w 7 . 7 RCW end 296.20 WAC. � )�O� <br /> VYIS-C � <br /> c <br /> Sig turu IOwnedConlractodAulhodz gen� a�e <br />