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DEC-11-01 10:64 FRON-NORTNNEST�/"CIIMR 206-374-OB34 T-165 P.02/02 F-301 <br /> PERMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7', EVERETT, WA 9e201, a25-257-8810 <br /> S17E ADDRESS PARCEL TAX t.D.N PERMIT N <br /> � ooi 49;" PI S�J � oo �� ��- vcoov�io� �6 �/Z-�1�� <br /> LEGAL LOT NO. BI.00K TRAC1' <br /> DESC. <br /> OWNER ADDRESS jPHONE 4>S <br /> Co✓�y C; � ass��A� � � o v � 4 q '� i' � � d S 7 - �€3 9 <br /> TENANT NaME CONTACT NAME I a o b PHONE <br /> �,�i I cw�r.; « c -.�� •� �,<< ; a81 - ��} no <br /> CONTfiACTCR . i ADDAESS f i CONTR.LICENSE II <br /> W t S �D ! a Pu J 'Th�rv� �- �°•�- � <br /> PHONE 2ob - 2F1 •• 44.: � j � �G+Nf���f S4�C� <br /> , e.�t FPiS9 I <br /> PROPOSED USE OF SUIL[IING DBuilding �y Meehanical� Addition MEAT SOURCE <br /> PERMIT [,� Combi�atlon [} Plumbing WORK Nmration QEladric <br /> �`� R TYpE l� Demolitfon D Sign TYPE Now 1:1 Gas <br /> U Spri�wer RepaidMaint. U OU�ar <br /> CONTRACT PRICE OF WORK!t �. V p J CITY OF EVER6Tf LOCAL SALES TA%CODE IS 3106 <br /> WORK DESCRIPTION <br /> — vt„�-.ye o { �o �, �� � d�� 5 <br /> QJ T C ? ^f '�K/�n V.r.r. <br /> PLUMBINIi MECHANICAL <br /> NO. TYPE OF FlXTURB OR ITEM NO. TYPE CF Fl%TURE OR RHM <br /> WATER CLOSET A/C-A•'HANDLING UNITS <br /> BATHTUB � FORCED AIR SYSTEMS <br /> _ LAVATOFY(WASH EtASIN) HEAT PUMP <br /> _ SHOWER _ UNIT HEATERS <br /> KITCHEN SINK&DI:�POSAL _ CLOTHES ORYEfi <br /> DISHWASHER � RANGc HOOD <br /> LAUNDRY TRAY _ WATER HEATER <br /> , CLO7FiES WASHER � 41ETAl FIREPUICE/STOVE <br /> _ UFINAL _ FIREPWCE INSERT <br /> � DRINKING FOUN7AIN _ GAS FIREPIACE <br /> � FLOOR DRAIN _ GAS RA�GE <br /> _ BACKFLOW PREVEI�'CER � GAS PIPING <br /> SINK(SERVICE/BAF/MOP/ETC.) _ EXHAUST FAN <br /> u OTHER OTHER <br /> I HEREBY CERITIFY 7MAT I N.iVE READ ANG EXAMINED TNIS APPUCAl10N ANO KNOW TME SAME TO BE TRUE AND CORpECT. ALL <br /> PflOVISI0N5 OF UWS ANO bHI01NACES GOVERNING TT11S TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIflED MEREIN OR <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PRESUIdE TO GIVE AUTMORiTV TO VIOLATE OR CANCEt,THE PROVISION OF ANV OTY1�R <br /> STATE OR IOCAL I.AW qBCaUUTING CONSTRUCTON OR THE PERFORMANCE Of CONSTF.UC`ION. THAT I AM AUTFIORRlD BY THE <br /> OWNBR OF THIS PflOPBRTY TO PERfORM THE WORK fOR WHICH APP4CATION IS MAOE�M1D I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 Ri:W AND 296200 WAC. <br /> ��-�/�}/-: <br /> Sign t o Owner/ContraaodAutho ' gent at� <br /> � <br />