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DEC-28-2005 09:56 FROM:PERMIT <br />SI i = '1DDRE55 <br />LEGA LO� . � <br />OESC. <br />4257756315 T��:42525T6857 F.2 <br />PEaMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />475-257-8810 — FfUi425-257-8857 <br />I PARCEL TAX I.D. !i <br />' �►' �0(p�DS�CJG� <br />BLOCK TR.4CT <br />nuunesa <br />�te r� .��1 �ti �'� -� ce�. !�-e�✓ Or �.�e�# <br />TENANTNAME <br />�� <br />cou>��N �.'I{��n�``'�� ��V1C4! <br />PNO��- wy' /�L� z�C.{� � <br />�'—ts y <br />AROPOSED I1SE OF BUILOING <br />S �`. <br />CON7RACT PRICE OF WORK <br />CONTACT POR P <br />,C,r.2d� <br />ADDRESS <br />PERMIT lt <br />PHONE <br />yZS 2.�r7 8�5% <br />ZIP CONTR.LICEYSEfI <br />''�i= �9��9 ; �J'/�it=J9�i c�g <br />B�ilding Mechanlcal <br />PERMIT g Cqmbinatlon Plumblr�g <br />NPE U Demolilion Sign <br />U Sprinkler <br />� <br />Atldltlon <br />WORK Alierefion <br />iYPE New <br />RepaldMalnt. <br />HEATSOURCE <br />Elepnc <br />G�s <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS :105 <br />WORK OESCRIPTION <br />.�f v� �.I f 9aS Fi r�e plarQ `1N��e.-� � 10 � <br />N0. � TYPE Of FIX'r:1RE OR ITEM <br />WAT[R CLOSET (TOILET) <br />BATHTUB <br />LAVATOPY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRVTRAY <br />C�OTHES WASHER <br />URINAL <br />�RINKING FO�!NTAIN <br />FLOOR DR.41N <br />BACKFLOW PREVENTER <br />SINK (SERVICFJBAR/MOP/E'fC.) <br />OTHER___ ___ <br />o f�a.1'��P/''�J <br />NO. I TYPE OF FUCTUriE OR ITEM <br />A/C — NHAN OLI NG UNITS <br />fORCED AIR SYSTEMS <br />HEAT PUI�AP <br />UNIT HEATERS <br />CLOT�IES DRYER <br />RANGEHOOD <br />WATCR HEATER <br />METAL FIR�P;ACE/STOVE <br />FIREPLACE INSERT <br />GAS FIR6PLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST F:�N <br />OTHER____ <br />I HEREBY CERI7IFY THAT I HAVE R[AO AND EXAMINED THIS APPUCATION AND KNOW THE SAh1E TO BE TRVE AND COFRECT. ALL <br />PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COIAPLIEL WITH WHETHER SPECIFIED MEREIN Ofi <br />NOT. THE GR4NTWG OF A PERMIT �OES NOT PRESUAIF TO GNE AUTHORIN TO VIOLATE OR CANCEI THE PFOVISION OF ANY OTNER <br />STATE OR LOCAL LhW REGULATING CONSTRUCTION OR THE PERFORMANCE �7F CONSTRUCTION. THAT i AM AU7HORIZED BY THE <br />OWNER OF THIS PROPERTY TO PCR�ORfd THG WORK POR WI IICH MPLICATION IS MADE AND I C01.1PLY WITH THE ST�TE <br />CON7 CTORS LA 27 RCW AND 2962a0�uo�, � <br />���a ,n,,,,�„ , � J ���-c��— <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />