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JUN-O6-OZ THU 09�41 RM EVERETT PERnIT SERVrCES FAX N0. 425 257 8�57 P. 02 <br />, - — — <br />PERMIT APPLICATiON <br />�� CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98201 <br />425•257-8810 - FAX 42.5•25 � -8857 <br />SITE ADORESS �'r'�-��� �� �' t8� I <br />8�'�JO F-v�`JLaRF�h t�il <br />LEGAI LOT NO. BLOCK TRACT <br />DESC. <br />�� e.�,A �z�F.�� <br />CONTACTNAME <br />�i'�c�t � 7 � �is ��xZ' <br />PARLEL TP Y I.D. M <br />�rct `'? 7�-R flt` <br />s�-- rt-c-reeK r� <br />y <br />b�s s� a��, ��PN��Y <br />�zHo`( too�7 � 21Z•6G1 � o�ioo <br />TENA4T YA�dE <br />No <br />CONTFACTOfi pDDRE55 <br />T� I�uRRMr Cbe,p�lny �To.a. I�lu�tNMY% <br />PHONE 3IO • Z Z.S '.3%�O <br />PqOPOSED USE OF BUILDING <br />Q�Tat L <br />COMR4CT PHICE Of WORK <br />P.o.t�ox ISoB <br />4��o�eae�a, w � <br />D- BuilJng D Mcehanical <br />PERMI7 pQ CombinaGon �] Plumbing <br />TYPE T3 Oamolifion C� Sit]n <br />U Sprinkler <br />PHONE <br />ZIP CONTR. LICENSF `. <br />4867y To►�uKC�. <br />q8c��k <br />ACCitior. <br />AlIer11ia0 <br />New <br />RCpairfM�int. <br />HEATSOURCE <br />Eletuic <br />Gas <br />omar <br />CRY OP EVEREiY LOCAL SALES TAX COOE IS ]f 05 <br />WOHKOESCfliPTON ����L�7�hb En��c.qQ� oPO,ct�O� IT+C(t7yhG Ins7att�TtoP{ � MC-� <br />5T4t2 F,ton� � S�oCuAuc , Q F�ni tnF.S . GFr.P.n.�•: up6..eAAE_ oF In'rt�Cicvc S��E <br />Ts IhG.CI�pE FuR/C11't(. Ov'7 eF �F'l4METFJI (,:ANS, /HtRJ�aKE.D "ii�ICkhCSS � <br />�.Xs-r F-�eac TcaR, t rtEc.� 'S4s�c F�r��sFtBs , <br />NO. I TYpE OF FIXTURE OR REM <br />WATER CLOSET <br />6ATHTUB �� <br />LAVA'OFY (WASH 9ASINj <br />SHOW[R <br />KITCHEN SINK 3 DISPOSAL <br />DfSHWASHER <br />LAUN�IiY TRAY <br />ClOT}+.ES WASHEF <br />URINAL <br />ORINKING FOUNTAIN <br />fLOOF DRAIN <br />BACKFLOW PREVENTEA <br />SINK �SERViCE�9AR/MOPIETC.) <br />OTtiER <br />NO. � TYPE OF FIXTURE OR fTEM <br />A/G - AlHANDLING VNITS <br />FORCED AIR SYS7EMS � <br />HEAT PUMP <br />UNIT HEATERS <br />CIOTHES DfiYEA <br />RANGE HO00 <br />WATER HEATER <br />MEfAL FIREPUtCElSTOVE <br />FIREPLACfi INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTfAN <br />O7HER <br />�I NE.^.EBY CERIT7FY THAT I MAVE AFJ�D AND IXAMINEO THIS APPUCATICN ANO KNOW THE SAME TO BETAUE AND CCFFEC7. ALL � <br />PRCVISIONS 0!' LA�Y& Ati0 9Hi0iNACCS GCVEaNMG TH4`. T'YPE CF WOPK WILL BE COMFL�ED WffH WHEfHER SPECIFICD HEFEIN Cfl I <br />iNOi. THE CFANTING OF A PEAMIT �OES NOT PRESUME TO GIVE AUTMOiiIT`! TO VIOLI7E OR CANCEI THE PPCV�SION OF ANY OT.'.ER � <br />STAT'c OFl LCCAI LiW F6GULIT�NG CO�iSi RUCTION Ofi TNE PERFORMANCE OF COtiSTP.UGT10N. THAT I AM AUTMORIZEO BV THE <br />CW'iEP OF TN�S PROPERTY TO PERFCFM THE'.VORK FOP :•MICM APPUCATIOY IS MACE AND I COMPI.Y WITH TNE STn7E I <br />i COA i pACTOFS lAW iC.7.7 FC'N ANO 296 _CO WAC. COF�T�C.T � n� : <br />� �i o a�H��-� : koki���� a��w-���� <br />n� Own cni c cUAulhonzotl Ager.t a(e a�f}t'EZS: ��ZG S�� Q��� %s �fl � <br />I i�yan ?'�I T'T (Appc�car+� ) S�A-r-r�e� 4aA 4b10 I � <br />' - T�fenn�:zo6•�K2•a126 <br />/lU <br />