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NOV-30-2y05 10:37 FROM:PERMIT 4257756315 T0:14252578857 P•2 <br /> ; i <br /> PERMIT APPLICATIO <br /> CITY OF �V�RETT PERMIT SERVI , ES <br /> 3200 CEDAR STREET, EVERETT, WA 982G� <br /> 425-257-8810- FAX 425-257-8857 <br /> i <br /> SITE ADDRESS �' PARCEL TAX LD.# PERnuI�- <br /> 22 �. p atrp,t r4-t.re' UoY39 I c� 7 �1 � / l � S 3 <br /> IEGA LOTNO. BLOCK i TRACT <br /> OESC. � <br /> UWVER � ADDRESS • ZIP PHONE <br /> aI�Z l7A-�f.S 22la t�tt�� f�e �/Z�G �'?o �z5 ZSz S�3d� <br /> TENANT�NAME CONTAGTFORPERMff PNONE <br /> �al e �✓s i � �(.-��dti yzr 2� 8�s.�' <br /> CONTR CTOR ADORESS ZIP CONTR.LICENSE N <br /> PHO�� �'D�� � i �q�, k`e � ��/�c��lIC.I/7I Q4 <br /> y s� �-� '� �i9 <br /> PROPOSED USE OF BUILDING �� Bullding � Mechanicat Addltlon HEAT SOURCE <br /> PERMIT CAmbinalion PlUmbing WORK Alleralion � EleUric <br /> (^ ? TYPE ! DemollUon Sign �7YPE � New Gaa <br /> O �'\ I � � Sprinkler RepalrRdaint Olher <br /> i <br /> CONTRACT PRICE OF WORK y .:..+ CITV OF EVERETT OCAL SALES TAX CODE IS 7105 <br /> l �D � i ' <br /> WORK OESCRIPTION i I �',�""' <br /> 9�l S �(k-�-�1� '�-U� "��"U'-.�L� <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR ITEM �� NO. TYPE OF FIXTU E OR ITEM <br /> WATER CLOSET(TOILEI) i ,_ A/C-A/HAND NG UNITS <br /> BATHTUB 'I _ FORCED AVR S 'STEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER ' _ UNITHEATER <br /> KITCHEN S�NK E OISPOSAL I ,_, CLOTHES DRV R <br /> DISHWASHER '� RANGE HOOD�I <br /> LAUNDRY TRAY �. = WATER HEATEE2 <br /> CLOTHES WASHER �, ,_ ME7AL FIREP CEIS70VE <br /> URINAL I _ FIREPLACE IN ERT <br /> DRINKING�OUNTAIN i _ GAS FIREPLA .� <br /> FLOOR DRAIN � _ GAS RANGE i <br /> BACKFLOW PREVENTER ,_ GAS PIPING <br /> SINK(SERVICEIBARIMOPlETC.) ' _ EXHAUST FAN <br /> OTHER � _ OTHER <br /> — i <br /> I HEREBY CERITIFY THAT 1 HAVE READ AND FKAMINED THIS APPUCATION AND KNOW THE SAAL=T BE TRUE AN�CORRECT. A�L <br /> PROVISIONS OF LA5V5 AND ORIDINACES GC�ERN NG THIS TYPE OF WORK WILL BE CO�dPUED WIT�i WHETHER SPECIFIED NEREIN OR <br /> NOT. THE GRANTING Of A PERMIT DOLS N�T PRESUMF TO GIVE AUTHORIN TO VIOLf�TE GR CANCEL THE PROVISION OF ANY OTHEP. <br /> STA7E OR IOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONS7Rl�CTION.�THAT 1 AM AUTHORIZED BY THE <br /> 01NNFR OF THIS PROPERTY TO PERFORM1I THE WORK FOR WH�CH APPLICA�ION IS MADE MD I COMFLY W ITH TME STATE <br /> CONT CTORS LA 27 RCW ANO 296.20 � <br /> �4 ��� �i13� ds' i <br /> 51 at re of OwnedConlractorlA � rized Agenl , � Date <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTE(� <br />