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JUIJ-6-2006 06:23 FF.0t1:PERDtIT 4257756315 T0: 14252578857 P•1 <br /> P 'Lr2MIT APPLICATIG�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA 9820� <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE APDRESS � �, PARCEL TAX I.D.tt PERMI7 p <br /> OZ Je-(,c.G�� l�-e-_L������y3o%70v fY�c�(�c�Co -r��9 <br /> LEGA LOTNO. BLOCK� TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PNONE <br /> r--e� � ��-�z ��oz ��l�a��-c_. 9�-zas y��-�z9� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> J�GCGu—�.- I �/1�� yzS 27r� — S `-�5� <br /> �p�pC�7�p� �' ���n' ADDRESS ZIP CONTR.LICENSE fl <br /> R A _ <br /> (L'J C.�lA-J'�i�lg�i c�g <br /> PHO��O �-'D L y7LLJ � �V'C,�i. �/� "W�L���I7 Jr <br /> PROPOSED USE OF BUILDING Building �Mechanical I �Additlon I HEAT SOURCE <br /> � �� I PERMI7 R Combinatlon Plumbing WORK Alleration �Eledric <br /> TYPE � �emolilian Sign TYPE New ��s <br /> Sprinkler RepaldMalnt. Olher <br /> CONTRACT PRILE OF WORK � �'1 .� CIiY OF EVER[TT IOCAL SALES TAX CODE IS J105 <br /> WORK DESCRIPTION <br /> oJ� l.v�,l� ��-�— 7��� c� Gn.e�t <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ PJC—A/NAIJDLING UNITS <br /> BATH7UB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PIIMP <br /> SHOWER _ UNITHEATERS <br /> KITCHEN SINK 8 D�SPOSAL _ CLOTHF.S DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRl+Y � WATEF.HEATER <br /> GLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREP�.ACE INSERT <br /> ORINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN _ GAS IZANGE <br /> BACKFLOVJ PREVENTER _ GAS PIPING <br /> SINK(SERVICEIBAWMOP/ETC.) _ EXHAUST FAN <br /> OTHER _ _ OTHER <br /> ( <br /> I HEREBY CERITIFY l'HAT I HAVE REAO AND E.U+h11NED THIS APPLICATION AND I<NO��THE$'.��.�E TO PE TRUE AND CORREC i. ALL <br /> PROVISIONS OF LAV✓S AND ORIDIIJACES GOVERNING THIS TYPE OF IVORK WILL BE COAIPUED N'ITH N'HETHER SPEGFIED HEREIN OR <br /> NOT. THE GMIJTING OF A PERh117 DOES NOT PFiESUIdE TO GIVE AUTHORIN TO VIOLATE OR CANCEI THE PROVISION OF ANY OTHER <br /> STATE OP.LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORI.IANCE OF CONSTRUCTION. THAT I Afd AUTHORIZED BY THE <br /> ON'NER OF THIS PROPERII'TO PERFORId THE WORK FOR WHICH AFPUCATIGh IS MADE AND I COMPLY WITH THE STATE <br /> CONTR GTORS LA 21 RCVJ AND 296.'.0 /_ /���� <br /> l�.cr��. 1i�1��s.�,c I C <br /> �JC <br /> SI �l rrolOwnedConliacbdA � rizedAyunl Dal: <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />