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DCT-7-2005 09:21 FP.QI:PERIIIT 42577�6315 T0:14252578857 P.1 <br /> PEaMIT APPI.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425•257-8857 <br /> to �--0 5 <br /> SITE ADDRE55 pARCEL TAI(I.D.N PERMiT• <br /> �/os ��.hur.rf-/�vL oo Ilo �-.rx�3� �- � p _ <br /> LEG LOTNO. BLOCK iRACT <br /> DESC. <br /> OWNER � AOORES ZIP PNOHE <br /> Da� V'a ��c�� ��os ����Kr�c q��-� �-�Zr-Zs��iq� <br /> TENMIT�NAME CONTACTfORPERMIT PNONE � <br /> f��-� � �C-r�d� yLs- 7 zo 3� <br /> CON CTOR ADDRE55 21P CONTR.UCEN9E II <br /> W"�s�l �I'ta�t� �-rUJIQJ <br /> PM� y-8z 7w Z-�� 7h 4 '�'� ��`�Ef/9 C�1�Jyit��icZg <br /> PROPOSEO USE OF BVILOING Building I�Ci4echanical AddlUon HEAT SOURCE <br /> � PERMIT B COmbinati0n F_� Plumbing WORK �Allerallon �ElecUic <br /> � TYPE D DemoliHon �J Sign TYPE New Gas <br /> U Sprinklef RepalrlMainl. Ot�er <br /> CONTRACT PRICE OF WORK �(f b�� �� CITY OF EVERETT LOCAL SALES TAIC CODE IS NOS <br /> ! <br /> WORK DESCRIPTION ^ O �S � i �L_ � L/ <br /> --l�.r{�.11�h 5 9�.I `�crrt <<�Cr�.cp /-�ahnc, �z� F- � <br /> 1��.,� �e�.,�r �� w/ 9'�J ��f'�•t� <br /> PLUMBING MECHANICAL <br /> NO. TYPE Of FI%TURE OR I7EM NO. TYPE Of FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C-AIHANDIING UN1T5 <br /> BATHTUB � FORCED AIR SYSIEMS � <br /> LAVATORY(WASH BASIN) HEAT PUtdP <br /> ' SHOWER UNIT HEATERS <br /> KITCHEN SINK d DISPOSAL CLOT'HES DRYER <br /> DISHWASHER RANGE HOOD <br /> _ LAUNDRY TRAY � WATER HE�ITER <br /> CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE INSERT <br /> ORINKING FOUNTA�N GAS FIREPLACE <br /> FLOOR DRAIN GAS R.4NGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETG) EXHAUST FAN <br /> OTHER OTIIER <br /> I HEREBV CERITIFV THAi I HAVE f3EAD AN�EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF lh'ORK WILL BE COMPUEO WITH WNETHER SPECIFIED HEREIN OR <br /> NOT. THE GHANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOlA1E OR CANCEL TME PROVISION OF ANY OTMER <br /> STATE OR LOCAL U1W REGULATING CONSTRUCTION OR TME PERFORMANCE Of CONSTRUCiION. THAT I AM AUTHORI2E0 BV TME <br /> OWNER OF TMIS PROPERTV TO PERFORId THE WORK FOR WHICH PPI�CATION IS MADE AND i COMPLV WITH THE STATE <br /> CONT CTORS LA .27 RCW AND 2�3fi.20 <br /> ��� rn sru�� � 6 ��63— y'LS' �-7 S �s� <br /> Si a re ol OwnedContractodA rized Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />