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Dec 19 08 17:55a F,larilynn J Willard [05 525 1576 p 2 <br /> �- PERMlT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8870- FAX 425-257-8857-vuv.tiv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> SITE ADDRESS PARCEL TA%I.D.# PERMIT# <br /> L�rs % �iZ1� lc C1� ��C I � C�`f ' -U�� <br /> L[GA LOTNO. BIACK ACTORSUBOIVISIONY <br /> oesc. , ,._ 3� - - � _ ,=5 i�i i;c��r �l�iur��� 1� �� 0 <br /> OWNER . AOORE S CfTYRIP PHONE r � <br /> V;E�(A,( 7 �. N�A�;�l��N N ._l , ;L� <br /> �� ; ����,�� 7���� ��i�����>,��� l�v��J ����r_ �;� �:;� 5�� .���� <br /> TENMITNAME CONTACTFORPERMIT P ONE �`�G� �zL, . �(�h� <br /> �o�o�-I�l 5C'.�-1u�7_ h1�r;��.�(rcr�� ��ti,�,_AR� . <br /> E•MAIL ���Ilirn„r�'afn�. Gc <br /> - o� s Tr.�zi� <br /> CONTR.LICENSE% <br /> USE OF BUILDING MEAT SOURCE � CONTRACT PRICE OF WORK <br /> �IN:'�l_L (-r�I� � L�� J{�-�. l / — --- ��?_53CG`� <br /> �[lectric Gas Other <br /> WORKDESCRIP710N iIVu.T�� �_�— Iv GW �-- � t�NAL' �_ <br /> � <br /> PLUMBING MECHANICAL <br /> I NO. TYPr OF FlX7URE OR ITEM NO. TYPE OF FIXTUflE OR ITEIA <br /> Toilet - ' a�a[rc+gxtds2 ra M�=F:IL'.C�� <br /> _ Balhtub �L Porced air syslems S.j��,j VAfz u <br /> i _� Lavatcry(wash basm) = Gas plping <br /> Shower bValer heater <br /> Kitchen sink&disposal Gas(ireplace <br /> _ Dishwashor Ga5 ran{�e <br /> Cloihos washor Clo�hes dryer <br /> ^ Waler heater Range hood <br /> Sink (serviced�aUmopJelc.) Exh2ust lon <br /> � ! 6acMlcw prevenler Heat pump <br /> Urinal Unit healer <br /> Diinking Fountain Boiler <br /> F!oor drain Refrige�ation <br /> � Grease lrap \1'oodstcve <br /> Raot drains __. Other_________ <br /> _ Other_____ <br /> CITY OF EVEflETT lOC4L SALES TAX CODE IS 3105 <br /> 1 heraby coritify that I have read and ex�mmed[nis applica7ion and hno�r lhe same ro be Irue and wrrect. All provisions of laws and <br /> oroinaces goveming this lype of work will be complled with whuther specii�ed herein or noL The granling of a permit does not presume <br /> to give authordy lo violate or cancel the provision of any other stato or tocal law re�ulating construction or the perlomance of <br /> construction.That I am authorized by the owner ol Ihis property to pedorm ihe vrork for vrhich application is mado and I comply with the <br /> Stale Contractors Law 18.27 RC and 296.i20D WAC. <br /> i <br /> ll��� �1�i.�,�,n �� /i�.(J l,l./r� s�.-x. l� . • U4 , <br /> Si na re o O�vn ./ ontractor�uth rzQ9 A�ent Dalo �, <br /> U ' <br />