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MRY-10-2004 11:0H FROM: T0:14"�'S257B857 P.1 <br /> � , — <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320i. G�DAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.N PERMiTt <br /> }2CK�y�+I�U� 40y'?���i')7 ��"� n'�o9n5-oo� <br /> LEGA 107N0. BIOCK TRACT T! <br /> �ES� <br /> OWNER AUURESS ZIP PMOKE <br /> rLt� �c �or�f� i7ts TZuc-Ir.e.►� �v��ar 3S9 ���p <br /> TENANT NAME ^ COATACT FOR PERAAI? PHONE <br /> � i L'1/UD�4 7rh��� S�J`�7o 3z8Q <br /> ��C�TORn� � � J ,C!^ �, ADDRE�S� /_v _ 21P CONTR.LICEN8E� <br /> rn r� L W—rV «U 2`f�L.L ,!A r�J,�7 ^� <br /> PHON !X� �ZS Z 7 ��v —"—��1� �C �9� (NK✓T��J 7 /IU7 <br /> PROPOSED USE OF BIIILDINO BuilAinp �Mechanical AddMhn NItAT tQURCE <br /> S� PERMIT R CombMatbn Plumbinp WORK R Allentini �E�tAc <br /> TYPE D DemoNtlon Sign TrPE D New Ga, <br /> U Spdnkler U p�pmrnA�n� i 9�er— i <br /> CONTRACT PRICE OF WORK /^� � ^ GITV OF EVERETf�OCAL SAL'ES T11R CODE 19�tOS <br /> u, <br /> WORKDESCRIPTION � ! C � ��, ` , '' L.y � <br /> `�� w�.� <br /> PLUMBING MECMANICAL <br /> NO. TYPE OF flXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINK 8 OISPOSAL CLOTHES DRYFR <br /> DISHWASHER RANGE HOOD <br /> _ LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPIACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICEIBAR/MOPIETC.) EXHAUST FAN <br /> OTHER OTHER <br /> i HEREBY CERITIFY THAT I MAVE REAO AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPIIED 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 ANV OTHER <br /> 57ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. T1iAT I AM AUfMORIZEO BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE YJORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONT 70P.5 LAW 7 RCW AND 296200 WAC. <br /> / r��� ���/V4 <br /> Slg ure f OwnertGontractorlAutho e Agenl Date � <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />