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MRR-14-2005 11:47 FROM: T0:14252578657 P.5 <br /> —� <br /> � <br /> PERMIT AP?LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE'fT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - DEBIT 8 CREDIT CAROS ARE NOT ACCEPTED <br /> SITE AOORESS P RCEL TAX I.D.f1 PERMIT# <br /> ;7zl D�l�-eS R�� l� 4?3�'z 3 su� �/� ;;� i�;'- � -� <br /> v L- <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER AODRESS /����,t�'21p PHONE <br /> }�dae''f�� '�'_�z/ Ckr k�i/' r4,� c�/4 �zo l �ZS � 7145 <br /> TENANT NAME � CONTACT FOR PERMR PHONE <br /> � f��l�.. �,�'zr ��a 3� <br /> COI�TRA�TOR� �7 _ _ � (�_ _ _(/w�, qpORESS CITY2IP PHONE <br /> INTTC/ T//IJ/� V�'7V uv <br /> CONTR.LfCEq/'TJHIG / 71�J> � �7'¢7/L��C� rV ��wY "T� �Y�� <br /> � <br /> USE OF 8UIl01NG HEAT SOURCE CONTRACT PRICE OF:'/ORK <br /> Sr� _Electric XGes_Other ��J� � <br /> WORK DESCkIPTION <br /> g �. �, y�1 c��.- he��- c6�i� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE QR ITEM NO. TYPE OF FU(TURE OR REM <br /> _ Toilet A/C—air handGng units <br /> _ Bathtub Forced air systems <br /> Lavatory(w:,sh basin) Gas piping <br /> _ Shower Z Waterheater <br /> _ Kitchen sink 8 dlsposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> _ Clolhes washer Clolhes tlryer <br /> _ Laundry tray Ranpe hood <br /> _ Sink(service/barlmopletc.) Exhaust fan <br /> __ BeckOow pravnnlnr Heat pump <br /> ,_ Urinal Unit heater <br /> _ Drinking Founlain Bo(ler <br /> _ Floordreln RefrigeraGon <br /> _ Gresse trap Woadstove <br /> _ Roof drains Other <br /> _ Other — <br /> CITY OF EVERETT LOCAL$ALES 7AX CO�E IS]105 <br /> I hareby cenli(y thet I heve reed enC exemined Ihis epplicaUon and know the same lo be We and correct. All provinions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specified herein or not.The grenting ol a permft does not presume <br /> to give authority to violate or cancel the provision of any other sWle or lacat law reguiating conslrucUen or lhe peAormance of <br /> constrvction.That I am authonzed by the owner of Ihis property to pertorm the wark forwhich appllcetion is medo and I comply with the <br /> State C�ont(tactors La�Cv 78 CW and 296.200 WAC. � / ��� <br /> ! /1 ���C j:�X �� <br /> Signa e neUConVacror/Authonzed nt 2�8 <br /> � I <br />