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JRN-13-2005 08:02 FROM: <br />T0:14252578857 P.2 <br />PERIV�IT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIdNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADORESS <br />Zo32 v,r <br />LEGA LOTNO. <br />l�es ;9-►-en.r <br />TENANTNAME <br />CONTRACTOH <br />CONTR. LICENSE / <br />W IqSFf lC <br />U9E OF BUILDINO _ � <br />C� <br />V <br />ina. /` <br />BLOCK <br />2 032 <br />PARCEL TAX I.D. M <br />cx�yo/syn6l7cb <br />TRACi <br />. AUORcS �'UP/�7'1 <br />�j�»�, �/e- cv� ld� <br />CONTACT FOR VERMIT <br />�-rnd� YhornQur,lf <br />AODRE9S <br />)Oi-rW�'Q � � <br />�-� �k. 4��95' <br />HEATSOURCE <br />_ EleMric � Gas _ Other <br />t <br />PHONE <br />�ZS77o3� <br />CITV2IP VHONE <br />�� 2�Z �`�� <br />CONTRACT PRICE OF WORN <br />� �� ~ <br />WORK DESCRIPTION <br />�-as � � G��r� c�.�,�� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Tollat <br />BaNtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 3 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbadmopletc.) <br />Backflow preventer <br />Urinal <br />Orfnking Founlain <br />Floor drain <br />Grease trap <br />Rool drains <br />Othe: <br />NO. I TYPE OF FI7(TURE OR ITEM <br />A/C — air handling units <br />Forced alr systems <br />Gas piping <br />Weter heeter <br />Gas fireplece <br />Gas range <br />CloNes dryar <br />Rangehood <br />Exhaustfan <br />Heelpump <br />Unit heater <br />Boiler <br />Refrigeration <br />WoodStove <br />Other <br />CITY OF EVERETT LOGAL SALE9 7AX CODE IS �105 <br />I hereby ceriliy that I have raad and e�:amined Ihis appliwlion and know the same lo be W e and cortacL All provicione of laws and <br />ordinaces goveming this rype of work witl be complfed with whether specified herein or not. The grantlng of a permll does not presume <br />to give authority to violale or cancel the provision o( any other state or local lew regulating constrvcUon or the pertortnance ot <br />conswction. That I am authorized by tho ownur af this property to peAorm lha work for which applicaUon Ic mada and 1 comply wilh the <br />Stalo Contractnrs w 18.27 RCW and 296.200 WAC. <br />�.�„�A, ��ms�.,..71 ���3 ��S <br />