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;en; By: NP LaserJet 3100; a25824951fi; Cct-19�C� '�2:19Pl2; Paae 3/3 <br /> R�EaMIT APPLICATION —� <br /> �� <br /> CIT-Y G�F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREFT, EVERETT, �'VA 98201, 425-257-A810 �;���� <br /> SITE A�DRESS PARCEL TN( I.G# P�.RM{7N <br /> 2au8�'IEwCRF.ST,4�'F,EvGRF.TT. V.'A 98203 UOS679nu300�03 �/S/�) �. �� <br /> LEGAL LOT NO. BLOCK TRACT <br /> —1-�- <br /> �— ADDRESS � PHONE <br /> OWNER �,���avie�vck�sfnv[ ,c a�•523: <br /> �a�.): <br /> \1CCAI.LUM,IOHN • F.VP.KGTT,�VA 98203 ,_ <br /> CONTACTNAME PMONE <br /> TE��ANTNA— ME� r,��1CLAH1!.l, a25 xia-�i'-a �-i3: <br /> CONTRACTOR � ADDRESS � CON7R.UGENSEN <br /> TCftCOMPANY 1?601 13?NDP.V�NF. FASI�WIIC�)S'_UF <br /> fAST R'ATER l[EA 02/162U07 <br /> KIRKI AT:I`,��'A 99034 <br /> (-025)fi14-3124 — pddl�lon M TSOURCE <br /> @�tllding M�cbaNeo pl���tlon <br /> PRGPOSED U8E OF BUII_DING vrottrc �•���� <br /> DERMIT Camhln�Hon P:umbinp �,PF New �' <br /> TYPE O.moliUon S,pn qe elrRddnl <br /> CITY QF EVERETT LOGAL SI�.LE9 TA%CODEIS J'105 � <br /> CONTRl.CT PRICE OF WORK 5449.O0 __ ---- <br /> WORK DESCRIPTION Remove/tieplace Uas\Vatcr Neatcr <br /> �NANI A <br /> U 8 'n'p�OF f XI TUR�QR ITEM <br /> ryp O f U � � � NGAlNANDLINO UNITS <br /> WAtEII Cl08ET — FORCED AIR sYSTEMs <br /> � BATHTUB T-- MEAT PUMI' <br /> � LAVATORY (WASFI BASIN) —��-- UN!T HEATERS <br /> ^� SHOWER - '^-- �LOTHES DRYER <br /> NITCHEN SINK 6 �ISPOSAL —""' qpNGE f100D <br /> DISFiWF.SHER ""j WATER HEATEH <br /> --"— �,e.uN�RY TRl1Y --"- METAL FIRE?LACElSTovE <br /> — cLo7HES NtASHER ""� FIREPLACE INSERT I <br /> URINAI. —�- ppS FIREP:ACE <br /> � ORiNu.lNG FOUNTAIN GA8 RAN6E <br /> � FLOJR DRAIN "-'""'- GAS PIPINO <br /> BALKFLOW PRE�ENTER —� EY.HAUST FAN <br /> �f SINK (SERVICFJBAWMOPlETC.f —"' oTkER______�_.------------ <br /> --�- OiHER��_ — - �-_ _���_,--'-----'--- <br /> i� I HERE6VCERTIFY TNAT I HAVE RFAG AND E%AMWED Ril£APIJGAT�ON F'�6 KNOW THG SAME TU BE Ti3UE AND CORRFCLAIL <br /> II ORON/� !OTHE 3RANT14G OFO PE`FZMIT DOES NOTRPRESVIdE 0 G E AUTO�ORI,TY TO VIOLATE OR GAN El THE PRO�/'ESION OF ANV' <br /> �i <br /> OTMER STATE OR LOCAL LAW REGU4AT�NG CUN9TRUCTION OR THE F6FFORM4NCE OF CONSTRUCTION.�NAtI A�AUT�iOR�Z 1 <br /> � 9Y THE OWNER OF THIS PROPERTY TO PERFORN TNE WORK FOR WM�C�APPLICATION IS MACE ANC I GOMPIY WIfM T��E STAT[ <br /> iCONTRkCTOHS LAW 10.27 FGW ANO 296200 WAC. <br /> —�—��_��� G et0 <br /> .� - � .�a:t c "/ : 1N1972005 <br /> gipneturo ol OwnsdConl�+erodAuthoriaod Aeen� .�c� - >.^ � A, <br /> u�!M <br /> _��_-������� <br />