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JAN-10-02 WED 12:58 Ph ?VERETT PERHIT SERVICES FAX N0, '.5 257 8857 P, 02 <br /> -,�' PERMIT APPLICATION <br /> ��.� CITY OF �VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201, A25-257-8810 <br /> SITE AOURESS �� � PARCEL TAl(I.D.t P�E,�1MIj q �� <br /> �'-i��,� / ' f��, �rJ, j�C���� . ,������''��L�C� �� �I� <br /> I.EpAI LOTNO. OLOCK TRACT � <br /> DESC. <br /> OWNER . ' ADDRESS PHONB <br /> > >� �,, �1. �c��f �!��-3°�>S-U��-� <br /> h0��?i��- 1 .ZviS j -�� �i <br /> TENANiNAME CONTACTNAME PMONE <br /> ._ .-.,i �.i,.,-.. ..�. , .... .., . . <br /> �, �' � Lf25 —412J--�.SrSk� <br /> CONTRACTOR. - r+3 CONTR.UCEN9e Y <br /> ,� �r:-..n,i �_, NE �CIA C �irU tvrfOSS�P <br /> yz� � :� ,�' ° .. 1%.•EthS �143 <br /> PHONE$'2c� SS4.y� ,t� <br /> pROPOSE�USE OF 9UIL�INp pyildinp (� Mechenical 4aPnon NEAT SOURCH <br /> PERMIT B Combinatbn RPlumbinp WORK atorauon RE7ettrb <br /> TYPB U Demolillo� V Slgn TYPE � Naw ��..( G� <br /> U Sprinklor Repairrt,wn� Ll otnar <br /> CONTRACT PRICE OF WORK �J %%, � CITY OF EVFAlTT LOCAL BALES TAX CODE IS 1106 <br /> WORKDESCRIPTION �- � S � �lC �Z � /' S ���1 �7�'C`''1`- <br /> ���'�1:���`l �C (�� . . . <br /> F1.U!9191I44 NIECHANICAL f / <br /> N0. TYPE OF PIXfURE OR REM N0. T'Pfi OF FlXTURE OH ITEM �L-!,j� _. <br /> / <br /> _ WATERCIOSET ._ aC-NHANOUNdUNITS <br /> �ATIITU[t _ FORCEDA1R9Y9TEM9 <br /> IAVATORY(WASH�ASIN) _ HEAT PUMP <br /> ^ SHOWER `' _ UNIT HFJ�TER3 <br /> KITCHEN SINK&DISPOSAL _ CLOTHE6 DRYER <br /> ^ DISHWASHEF RANGE HOOD � �� ' <br /> I ,� �ql1NORYTRJSY �L WA7EHHEA'fEH <br /> ___, CLOTHES V�'ASHER ._ METAL FIREPLACFJSTOVE <br /> ^ URIN/�L T FIREPLACE IN6ER7 <br /> ✓ ORINKING FOUNTAIN _ dA9 FIREPLACE <br /> FLOOR DFIAIN _ �S RANGE � .. <br /> 6ACKFLOW PREV�NTHfl � QAS PIPINO ` <br /> _ SINK(SEiiVICE![�AR/MOp/ETC.) EXHAU9TFAN <br /> '_,_ OTtiEFi _..,.....--- _ OTHEf�_ <br /> I MEFFBV CERITIFY TMAT I HAVE HFAO ANO EXAMINED TT115 APPLICA710N AND KNOW TNE SAME 70 BE TqUE�4D CORREOT. Al� <br /> pROVI510NSOFLAWSANDORIDINACE540VERNINOTMISNPEOFWOHKWILLBECOMPLIEDWIT}1WHEME� 6PECIFIEDHEHEINOFi <br /> NOT. THE ORANTING OF P.PEFMIT pOES NOT PRESUME TO aIVE AUTNORIiY 70 VIOUTE OR CANCEL'TNE PhJVIS10N OF ANY O7HER <br /> STATe Oq LOCAL LAW REGULATINa CONSTRUCTION OR 1NE PERFORMANCE OF CONSTRUCTION. 7NJA 1 AM AUTHORIZED BY 7HE <br /> OWNEH OF TMIS PIIOf ERN TO PERFORM TF1E WOHK FOR WH1CH MPLICATION IS MADE AND 1 COMPLY WITH THE 6TA7E <br /> CONTR�CTORu UW 16.27 RC1�1 AND 286.200 WAO. . � <br /> i l' <br /> /,� ,i r ' ��% <br /> !�. t:.. , � � i� � y- - <br /> . SignaNrebTpwnor/Contrnctor/Aut odxo ponl Dato <br />