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DEC-20-2005 09:42 FROM:PERMIT <br /> 4257756315 T0:14252578857 P•1 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320G CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FA>: 425-257-8857 �Z�a0-�s <br /> PARCEL TAX I.D.# PERMi7 k i.5, <br /> SITEAD�RE55 d37�o9�ao � ,'i1��/z 'J�! <br /> Z�SOZ ��v-P-�V(�� <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. Z!' <br /> OWNER � - � ' <br /> ADDRESS ZIP PHONE J <br /> tps,� 1��13 (C_o �y�2 1�LDw �� vO ��"7sJ3 �l� �C�3� <br /> CUNTACTFORPERMIT ' n PMONE <br /> TENANT NAME � � I / i� J� �/�S ` I � ���� <br /> v /l�i GC � <br /> CONTRACTOR <br /> AODRE55 ZIP CONTR.LICENSE N <br /> c.URJ'N �l2Qr�c� �j'�v1C[J' � �ly�J'h�i�.l9�ictg <br /> PHONE `'� —`� �� k�' '� 9�/9 <br /> 2p(p �'L 7C�U �! <br /> Buildin Mechanical Addi�cn I HEqT50URCE <br /> PROPOSED USE OF BUILOING Q 9 ,j'-�- R ��ElecUic <br /> � I PERMIT I ) Combinalion �..1 Plumbing YJORK �_� AltereAon �_� Gea <br /> � 7Yf�E Demolilion U Slgn 7YPe �_S New <br /> B Sprinklar �� Repalrll.laint. V Olher <br /> CONTRACT PRICE OF WORK � � CITV OF EVERE R LOLAL SAI.ES TAX CODE IS 3105 <br /> i <br /> WORK UESCRIPTION���� � <br /> f( ��c., �n� <br /> �wf � ����N�3�� <br /> MECHANICAL <br /> PLUMBING <br /> NO. TYPE OF FI%TURE OR ITEM <br /> NO. T'PE OF FIXTURE OR ITEM <br /> W ATER CLOSET�TOI�ET) AIC-NHANOUNG UNITS <br /> BATHTUB � FORCED AIR SYSTEAIS <br /> LAVATORY(WAS�1 BASIN) . _ HEAT PUMP <br /> UNIT HEATERS <br /> SHOWER . — CLOTHES DRYER <br /> KITCHEN SINK 8 DISPOSAL RANGE HOOD <br /> DISHWASHER — y�rq1ERHE4TER <br /> LAUNDRY TRAY AIETAL FIR6PLACEISTOVE <br /> CLOTHES WASHER — �IREPLACEINSERI <br /> URINAL — GAS FIREP'_ACE <br /> � DRIP:KING FOUNTAIN — Gqs�qNGE <br /> FL'JOR DRAIN GAS PIPING <br /> BACKFLOW PREVENTER — Ey,HAUST F.4N <br /> SINK(SERVICEIBARlMOPIEI"C.) — O7HE�_ <br /> _ OTHER�.�.— — <br /> — I ----- <br /> I HEREBV CERI7IFY THAT 1 HAVE READ AND EXAMWEO THIS APPLICATION AND KNOW THE SAME l'O BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF lAWS AND ORIDINACES GOVERNI�G TNIS TYPE OF�YORK WILI BE COMPLIED W�7H lN4ETHER SPECIFIED HEREIN OR <br /> 5 ATE OR LOCALIL4W R GUV+TING COONS RUCTION OR THE PERFORMANCE OF CO STRUCTION, THAT I AM AUiHORI ED BY HE ER <br /> OWNER OF THIS PROPERTY TO PERFORh1 THE W ORK FOR R'HICH A�FL�,CAI ION IS M1tADE MU I COMPLY W ITH TME STATE <br /> CONTR CTORS LA 27 RCW AND 296.2�0�. ��' l /�� <br /> ����,/ " � �C/` <br /> "^'�'-"` � Dzle I <br /> Si art re of QN�ner CoMra�todA nzed Apen1 I <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED J <br />