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JUTA-14-2006 09:35 FPOII:FERMIT <br />4257756315 TO:14252576357 P.1 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />PARC <br />SITE <br />�Z ADDRESS E� � <br />LEGAL LOT NO. BLOCK TRACT <br />DESC.( <br />Let Uto) <br />TENANT NAME <br />CONTACT FOR PE <br />/"//1d�L- <br />CONTRA" <br />ADDRESS <br />ow <br />PHONE (iV cco <br />20l� z-S z y7�j� <br />PROPOSED USE OF DUILDING I Buitdiny �[ �Aochanic <br />PERMIT Combination Bl'lumbing <br />TYPE Demolition $ign <br />Sprinkler <br />21P <br />PHONE <br />CONTR. LICENSE A <br />L�i�Jfs'/�f97/ Ge <br />Addition <br />HEAT SOURCE <br />WORK <br />I./� clectdc <br />TYPE <br />IIteration <br />NewLGas <br />.epolr/Moinl. <br />Other <br />CONTRACT PRICE OF WORK / n'�;D I CITY OF EVERETT LOCAL SALES TAX CODE 15 3'105 — <br />WORK DESCRIPTION <br />PLUMBING <br />NO. TYPE OF FIXTURE OR 11EM <br />MECHANICAL <br />Ilo. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK d DIS'OSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />, RINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFI.OW PRFVFNTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />+ <br />_ <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT" <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />_ <br />y_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />I HEREBY CEP-TIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK �dILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THEOWNER OF HIS PROPERTY TOPERFORM THE WORK FOR WHICH ERFORMANCE UP CONSTRUCTICN THAT I A", ORI D BY THE <br />CH APPUCAT ON IS MADE AND I COMPLY WITH, THE STATE <br />CSOwneUConhacl0r/A I rized Agenl 7 <br />Date <br />DEBIT & CREDIT CARDS ARE; NOT ACCEPTED <br />