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From:Janes Company � 425+2G7+0303 081� 3008 11 :51 A606 P.001/002 <br /> 1 o 2 Pr --- <br /> .�CcY1C B(1� �l'�.'�CVPL��r A�S . <br /> � �i ';;, �' -'PERMIT APPLICATION � �5� <br /> r,UG 21 �� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> i <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> ' APPLICATIONS ARE ACCEPTED FIiOM B AM TO 4 PM <br /> SITE ADORESS PARCEL TA%I.D.R P MIT <br /> � � �r �v�e OC"�I"I1 GQ00 �7�� 0 -3a— <br /> LEGAL LOT N0. BLOCN TqACT ON SUBDIVISION <br /> oES�. y1 ao�-02 c 1�� r��d ��;res <br /> OWNER ADURE S CI /ZIP HONE �2S <br /> �a�,� } �c�c�n UJZbb�r 5�r:o2 �iuest 'i)s. F�v�R�tl �fB�;.R �3-5 <br /> TENpNTNAME CONTACTFOPPERMIT PMONE �S <br /> �� Jc�r� l�b�r E-MAIL '3 3 SS(�� <br /> ,k� C�mpr�t��� , iru._ 822� y�h#� ��, �=� i�+u�� �25� <br /> CONTR.LICENSEM���,^T�,�nM �� _I �� v� n�—'"C/��� <br /> l:.l- �/f-. L O''l� <br /> USE OF BUIL�ING ElectHc X SGa RCE aher CONTRACT PRICE OF WORK <br /> ��rrle f-� �1 Re� — � �,z3 s . �b <br /> WOFKDESCRIPTION 1����,( ���- `��L� ..{.k�e .�� �e `��� � <br /> -c� ��c���-ir�y �;,,�le.f ,��� (cic� ��eQ ��1`�e+n> <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEI�1 NO. TVPE OF FI%TUNE OR ITEM <br /> Toilot AIC—air handling unils <br /> �athtub Po¢ed air systems <br /> _ lavatory(wash basin) Gas plping <br /> � Shower Water heater <br /> Kitchen sink 8 dlsposal Gas lireplece <br /> Dishwa�her Gas range <br /> Clothes washer Clothes dryer <br /> __ Water healer _ Range hooC <br /> ,_ Sinh(service�bar/mople�c.) _ EaheuSltan <br /> OackAow preven!er _ Hoat pump <br /> Urinal Unil healcr <br /> _ Drinking Fauntain Boilor <br /> _ Floordrain Refrigoration <br /> __ Greasc Irap Woodst vo <br /> __ Roal dralns � � O�r_ � ' � _ <br /> Other <br /> CITV O'r EVERETT LOCAL SALES TA%CODE IS 7105 <br /> I hereby centity that I havo�ead and e�aminetl ihis appliwtion and know Ihe same to be Ime and correcL All provisiDns 01 lews and <br /> ord�naces goveming Ihis type ot work will be complied with whMher spec�lied herein ar not.Tho granlinq ol a peimit does not prosume <br /> �o give authomy�o violate or cancel ihe provision ol any othor state or local law regulating construction or ihe penormance ol <br /> conswction.Th,�t I �n authorimd by iha owner ol this property to pertorm ihe work lor which app�ication is made and I comply with Ihe <br /> Slatc Conir�( t ors L yL 18.27 F7CW and 296.200 WAC . /y <br /> 1_." ��-� ?y� �ZS�l.'O <br /> SignaNre ol O�� eriConlraclodA Iho� etl Agem . Dato <br />