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OCT-12-2005 11:32 FROM:PERMIT <br />4257756315 TO:14252578857 P.1 <br />SITE ADDRESS <br />LOTNO. <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 />FIK- 4'19 <br />PARCEL TAR I.D. <br />ZIP PHONE <br />Gwy-1wl r4s'�( ti , -1fy,T KAc4�?Yv qe2,d l �Lrzrz K6160 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />CONTRACTOR W d fH C .wn /(j (a IIF3� <br />ii f�J /'i� <br />�-'7w <br />LP CfO�/NT,R. LICENSE 0 <br />PHONE Rr1.IZ �LU/�'�.r_jK/1y(��df1�J,i'(/( <br />! 1— <br />�1 ,, �7 <br />i.VttU�"ll %,�L'� <br />PROPOSED USE OFKBJ'IR^W^INO <br />j] <br />TYPE <br />n BIIOdfq <br />CombinvWn <br />DSmobon <br />MedlSNlcnl <br />umdnp <br />Sign <br />WORKa7t <br />TYPE <br />HEAOURCE <br />EerL'It <br />Gn <br />Y"1PERMIT <br />n <br />cow <br />Sprinkler <br />CONTRACT PRICE OF WORK I �QQ L <br />— <br />CfTY OF EVERETTCAL <br />LOSALES TAX CODE IS 3106 <br />WORK DESCRIPTION ,_f c �� ��� '� •�i�� � �! <br />PLU I G <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO.. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBARIMOP/E1C.) <br />OTHER <br />_ <br />_ <br />_ <br />_CLOTHES <br />= <br />AIC-AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIRFPLACHSTOVE <br />FIREPLACE INSERT . <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER, <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />I HEREBY CERITI FY THAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE; HER SPECIFIED HEREIN OR <br />NOT., THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOFUTY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />GTAOWNER OF LOCAL OR IS OPER TTM O PERFORM THE WORKON OFOR WN CH APPLICATIOPERFORMANCE N MM* AND 1 COMPLY <br />ONSTRUCTIOK TI AM WITH THE D BY TIC <br />i <br />DEBIT rk CREDIT CARDS ARE NOT ACCEPTED <br />