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06/24/2008 10:39 FA% 425 257 BB57 <br />EVERETT PERMIT SERYICES <br />PERMIT APPLICATI4N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 – FNC 42�257•8857 – www.everettwa.org <br />� 001/001 <br />APPLICATIONS ARE ACCEPTED FROM B AM TO A PM 7—I `D� <br />SITE ADDRESS <br />�-I co � <br />LEGAL LOT NO. BLOCK <br />pESC. <br />NER —^ <br />\renu+rna e S L <br />� <br />c�� s ��- <br />CONTR, IJCEN3E 6 � (�5�.�—(� ' ( <br />(� ��L <br />USE OF BUILDIHG <br />I PARCEL?pO( I.D. N <br />, <br />( -- <br />7RACTOR SUBDIVISION fl <br />Ap0 E Clril IP � P <br />.�' � ��Jano ,L�. � <br />CONTACTFORPERMT VHONE <br />l�C_I �I e�l E.���.� <br />, <br />� �_���o <br />HEATsOURCE GQNTA <br />v_ Elactric „_ Gas � Other I�,�. <br />WORK OESCR�PTION . <br />�ns-� I I �1-�c,�� c�e.��ns �v«� nc P�0 3v , <br />���c� ��c,ku����' lam� na�� Com����� Cct��• <br />N0. I TYPE OF FlX7URE OR ITEM <br />i Toflol <br />B��hwD <br />tavalory (wosli basin) <br />ShowOt <br />� Kilr.hen �ink & dlsposal <br />^ pishwnshor <br />� Cbthea wushcr <br />_ Water heator <br />_ Sink (servtcn/badrtwplelc.) <br />Batkllow provonlot <br />Udnal <br />� Drinking FounWin <br />Fbpr drAin <br />__ GronFn tmp <br />Roof drdins <br />� Other <br />= a.s�� �o� <br />PRICE OF WORK <br />�,• � <br />NO. I TYVE OF FtlRURE OR ITEM <br />AIC — a!r hondllnc7 unils <br />� Forced alr syslems <br />Gas piping <br />J Wuterhoater <br />„_ Gas iireplaco <br />_ _ . Gas range <br />Clolho. dryor <br />Rengo hood <br />ExhNualtAn <br />�— H9atpump <br />'— lJnit hoelor <br />[3allor <br />RehigeiAlbn <br />, W a�dstove I % � (� <br />Othor Yl t <br />CITY OF EVEREIT LOC.LL 9ALES TA% COOE IS 7105 <br />I hereby c.ari�dy that I ��vo rAad and fsxaminod this oppllcal'wn nnd know Ihe samc to be truo �nd r.�rr�n;L All provisbns of laws a�d <br />orct�nacos govoming IMs typo a( work will be com�liod wllh whothnr npecilied horan or not. The c�ranliMa of a permit does rrol prosume <br />�o givo authority lo vblato nr rancr.l tho provielon o( any othor Ftnte or bc.el law roqu�atlnp constmction or Ne pcAortnanco ot <br />consWction.'fhat I om authn�L-ed lry thu ownor o1 Uiis proporly lo �x orm work fo� ��ch applicalion iy mado �nd I tompiy with Ihe <br />Swte Contn r� L ta. RC1v ana 2�0.20�.WAC �° � <br />��/���,'=��' � 3��1 E <br />