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JAN-16-02 WED 12:58 PM i 'ERETT PERflIT S@RVICES FAR N0, ' 257 8857 P, 02 <br /> I �-�� PERMIT APPLICATION <br /> �^`�!� CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,\NA 98201, a25-257-8810 S`� `D r, <br /> 0 oa�� � <br /> SITE ADDRESS CyI� T PARCEL TAX IA.! PERMIT q <br /> q30�- J `�1�0/�.. I.�k ��q_�i��?' /v1U'�C:`� -C <br /> v JTv"�'_ <br /> LECiAL LO7N0. BLOCK TqACT <br /> DESC <br /> OWNER � ADDRESS PHONE ��� <br /> SU�n-� � ryan -(- i/8���/ � 9� �� ��P 5' -�� 3�r -s��� <br /> TENANTNAME � I CONTACTNAME PMONE <br /> ,��J T/�C r✓!� � <br /> CONTRAC70R L.na,J W97�� ��RESS �,� � co��u�c�s��er� <br /> � ,��] 70 �- .,�� �-Z , `/3 A o <br /> PHON yrr�u-`-r��,e.�s � i c�C�,e.,��•�►=', 9 �`'�� � <br /> pROPOSE�USE OF 9UILDING � 6uilding �j Mechenical Aadaion HEAT SOURCE <br /> PERMIT Combination [, Plumbing WQRK R nueatwn ��=Electrb <br /> TypE �emolilion [� Sign TYPE D New I> �+s <br /> Sprinklcr � RepnirAdainL �.�•� 01hor <br /> � <br /> CONTRAC7 PHICE OF W ORK QcJ p � Clri OF EVERETT i.9CAL 6ALES TAX CODE IS 5105 _ <br /> ! <br /> WORK DESCRIPTION ���a ' .p �-� �-'� t ���,✓VL2,�L"�" �-� <br /> J <br /> .e,(�ec_-(-r-�� C1�f--cr �-�--t`�r <br /> p�l�M¢�G MEGHANIGAL <br /> N0. TYPE OF FIKfUpE OR ITEM N0. TYPE OF FI%TUHE OR IIEM <br /> WA7�f1CLOSEI' _ AIC-A/HANDLIN(iUNITS <br /> J AATiITUfI FORCEDAIRSY9TEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> � SHOWEFl _ UNIT HEATERS <br /> KITCHEN SINK 8 UISFOSAL _ CLOTHEfi ORYER <br /> L1ISHVJASIiER RANGE H000 <br /> __ l.Al1NDftY TRAY � WATER HEA7ER <br /> �, CL07HES WASHER _. METAL FIFIEpLACE/S?OVE <br /> ,^ UR�NAL FIREPLACE INSER7 <br /> _, ORINKING FOUNTAIN _ GAS FIREPLACE <br /> fL00R DpAIN _ GAS RANGE <br /> BACKFLOW PREV�NTER �AS PIPING <br /> _ SII.K(SERVICE�6AF�/MOP/ETC.) � BXHAUST FAN <br /> � OTH'cR <br /> � OTI1Eii__........__.�_ — <br /> _�_. _ _.'-_-.� _ <br /> I MERFOY CCRITIFY TNAT I HAVE RFAD ANO E%AAtINEO THiS APPL'GACIDN ANl KNOW THE uAME TO 8E TRUE AND CORRECT. ALL <br /> pFOVi�lONS OF LAWS AND ORIUINACES GOVEHNING ThIIS T'PE OF WOHK WILL BE COMPUED WITM 1YHEfMER SPECIFIED HEREIN OR <br /> NOT. TNE GHANTW G OF A PERAIIT UOES NOT PFESUME TO GIVE AUTHORIN 70 VI04ATE OR CANCEL THE PROVISION OF ANY OTHER <br /> WNEH Of-T�H S PIIOPERTY O PERFORM7HE\YORK FORNWMIGH A PL7ICATION IS MADE AND 1 COMP V W TH THE SfAI�D BY THE <br /> COYTFLICTORS LAW 1027 RCW A4D 2962W WAC. <br /> � �.��L'--�� � /�� <br /> � . <br /> �; <br /> Signaure o!QivnedContmctoqAuthorized Agrnt Dalo <br /> � �-'- <br />