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JUL-17-2006 12:09 FROH:PERNIT 4257756315 TO:14252578857 P.1 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 —FAX 425-257-8857 <br />SITE ADDRESS <br />Vl�/G2'l <br />PARCEL TAX I.D. # P�gM T?J� <br />IEGAI LOT NO. <br />BLOCK <br />TRACT PWQle C-J ( f-F WO ( O <br />DESC.`fGLa-(.Llej, <br />/�r" <br />OWNER Al)URESg ZIP PH E <br />S�• Gla I ✓_ 3oz� w-UIQ�rmcl/lEw %�✓ y�za! `-fzS'"zs L/sue <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CO(/NUTRAICTORV ADDRESS ZIPrl� CONTR. LICENSE # <br />PHONE <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />AddWun <br />HEAT SOURCE <br />PERMITB <br />Combinalion lumbinq <br />WORK <br />g Alterationln� <br />Electric <br />TYPE (U, <br />Demolition u Sign <br />TYPE <br />I�)i New <br />RepalrlMainl. <br />{S/• Gas <br />L� Other <br />Sprinkler <br />CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FUCTURE OR ITEM <br />WATER CLOSET (TOILET) <br />A/C—A/HANDLING UNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />_ <br />KITCHEN SINK $DISPOSAL <br />CLOTHES DRYER <br />_ <br />_ <br />DISHWASHER <br />LAUNDRY TRAY <br />Z <br />RANGE HOOD <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />_ <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />_GAS <br />FIREPLACE <br />_ <br />FLOOR DRAIN <br />_GAS <br />RANGE <br />_ <br />BACKFLOW PREVENTER <br />GAS PIPING <br />_ <br />SINK (SERVICEIDAR/MOP/E7C.) <br />EXHAUST FAN <br />_ <br />OTHER <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND F_XP,Iv11NE0 THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF TAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERT-ORhiANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT C�T�O,R�S/LA .27 RCW AND 296.20 <br />Si6tiature o caner Contractor/A rizetl Agent ate <br />DEBIT $CREDIT CARDS ARE NOT ACCEPTED <br />