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JAN-23-02 ,o:=, F����S��RMIT APPLICrATIUN T-:o� P.o,�ot F—�o� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEAETT, WA 99201, 425-257-8810 <br />SRE ADDRESS <br />Wei�w�oYP fi�Q <br />oesc. <br />�e�n�� s O y'��r <br />TENAN�TyNAME <br />'T� <br />CONTFi�►CTOR <br />W �SGL� <br />PMONE ,2 a 6 — 1� 1. - y'i- v <br />PROPOSED USH OF BUILO�NG <br />S ��2 <br />PERIIAR <br />rrae <br />CONTpACT PRICE Of WOF K� S <br />WQRK OESCIiIPT10N <br />PARCEL 7AX I.D. • <br />O D�! 4.J—g U i�-f �v 3 0 <br />ADDRESS <br />5,�.� � <br />S <br />CONTACTNAME <br />c�.�. G.� l� �.�+ <br />ADDRESS <br />�av a T�ar,.� �Ce �aw <br />�� <br />PERMIT M , <br />!M�'�v/ ��5 <br />PHONE a,, y,r' <br />3P`J'- 36�.1� <br />� n d PMONE <br />3 �►' `G 6 d p <br />CONTR. LICENSE • <br />Wq�Sf�.��r9 Sp1c�.J <br />Buildiny Machanical j] Additbn HEAT SOURCE <br />Combination PlumCing WORK p� Nbntion Euctric <br />Demolitbn Sipn TYPE ' B Nw+ �Ou <br />Sprinkler I..) RepelnMaint dher <br />CfTY OF EVEqETT LOCAL SALES TAX COD! It 0105 <br />"��nwti,Q 0�.�.� ^J A3 <br />NO. � TYVE OF FIXTURE OR REM <br />WATER CLOSET <br />snrr�rue <br />LAVATORY (WASH BF,SIN) <br />SHOWER <br />KITCHEN SINK & DISF�OSAL <br />DISHWASHER <br />laIJNDRY TRAY <br />CLOTHES WASHER <br />URINAI. <br />DRINKiNG fOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEMER <br />SINK (SERVICElBAR/A10PlE7C.) <br />OTMER <br />"�Cl ��S �v`a�� �e^1'r <br />C L <br />N0. � TViE OF FlXTURE OR IT[M <br />_ A�C-AMANDLINGUNITS <br />_ FOFCED AIR SYSTEMS <br />_ HEAT PUMP <br />^ UNIT NEATERS <br />_ CLOTHES DRYER <br />�RANGEHO00 <br />1 WATER HEATER <br />� METAL FlREPLACE/STOVE <br />__ FIREPLACE INSERT <br />_ GAS FIREPLACE <br />` GAS RANGE <br />� GAS PIPIN� <br />_ EXHAUST FAN <br />� O7MER <br />I HEREBV CERITiFV THAT I HAVE READ AND p(AMINED THIS APPLICA710N AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORi01NACE5 GOVERNING TMIS TYPE OF WORK WIL� BE COMPUED WITH WMETHER SPECIflEO NEREIN OR <br />NOT. THE GRANTING OF A PEF MfT DOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL THE PROVIS�ON OF ANY O7HCR <br />STATE OR LOCAL UW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTF7UCTION. TNAT I AM AVTHORIZED BV TliE <br />OwNER Of TiiIS PROPERTY 7�� PERFOpM iHE WORK fOR WHICH APP�ICATION IS ��ADE AND I COMPLY WITH THE STATE <br />CONTqACTORS LAW 18.27 RCN� I1ND 296.200 WAC. <br />