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JAtJ-10-2011 19�57 FP.OM: T0:14252578857 P. 1�1 <br /> � <br /> PERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.vrg <br /> APPLICATIONS ARE ACGEPTEp fROM b AM TO 4 PM <br /> SITE ADDRE93 PARCEL TAX I.D.p PERMIT N <br /> CX� -rf 1 � ��D�� - 05� <br /> LEGn LOTNO. �IOCK TRACTORSUBDMSIONN <br /> D�SC. <br /> OWNER AD�RESS CITVI IP PHONH <br /> �t c� C'�[�.� Cor�Sa n��-;r�rr,� �v� F�.c��-,�sr:�3 l.ta`.,-��- s��� _ <br /> T[NANT NAME I CONTACT FOR PERMIT PHONE <br /> n U�6-�So- Ib0'� <br /> �� Q'� E�1AIL <br /> N Nk <br /> CONTR.LICENaea � ��l��o �CCo�UG'JQ/�r�nW�� � ���� <br /> ncK-��j1 S 9roE1b'� �' S a'�- I�� <br /> US6 OF DUILDINO HEAT SOURCE CONTRAC7 PRlGE OF WORK <br /> „_Eleclric ,�,Gea,�Other �l <br /> , --- <br /> WORK DESCRIP710N <br /> PIUMBING MECHANICAL <br /> NO. TYPE OF FlXTUR&OR ITEM ' N0. 7YPE OF FUt7URE OR ITEM <br /> 7oitol NC—air handling units <br /> ~ Bethlub ,.j_ forcodalrsystoms <br /> _ lavatory(wash basin) Gas piping <br /> Shower -" Water healor <br /> T Kilchen sink 3 dl6po9al _ Gas firyplace <br /> � Dishwasher _ Gasranpa <br /> � Cbthes washor _ Clothos dryer <br /> Waler heater ,,,,�,_ Ranpo hood <br /> � Slnk(servicolber/moplolc.) Exhaust fan <br /> ,� Dacktiow prevontor � Heat purnp <br /> Urinal Unit hoater <br /> ` Dnnkinp Founleln �— Boller <br /> � F�oor droln � Rofri�oraQon <br /> Graase trep W�d��ovg <br /> � Roof drainn ' , Other �_ <br /> ,^ Olher <br /> C�TY OF EVER[Ti LOCAL SAlE3 TAX CODE IS J105 <br /> I hAroby ceritify thet I havo roed and examineA this applicaUon end know Iho sama to bo truc and cortocL All provl�ionc of lawe and <br /> ordinacos Oovorninp this ly{�e of wortc wlll be complincl with whether specllled hareln or not.Tha 9rantinp o(a permil does nol precume <br /> to glva outhoAty to vlolala oY cancol tho provlslon o(a�y o�hor state or bcel lew reguleting conalrvclion ar Ihe peAormance of <br /> constructlon.That I am authorized by tho ownor of this property to partorm tha wOrk forwhich 00pllcation is mod0 and I comply wifh lhe <br /> S o n Uors Law 18.27 RCW unA .200 WAC. <br /> _� <br /> aWro of Owner! n toqAuthodzed Apen[ ate <br />