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JAN-24-02 11:39 Fk71f110RTHNEST�'"SIWAR 206-3T4-OB34 � T-223 P.Oi/O1 F-123 <br />PCRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SITE AODRESS ty PARCEL TAX I.D. N PERMIT r <br />3!16 _� Sy -`�� S� 4U 3y6 �aoyoia oo _ mc�ao�-o3 <br />o�s�. � L <br />OWNEp <br />,�Ve IIVQ� <br />TENANI`'i�AM�/^,� <br />Gl f �7 <br />CONTPACTOR �E S C O <br />PHONE �v� � �� �7��U <br />pROPOSEd USE OF EUILDING <br />S� <br />CONTRACT PRICE OF WOpK ` <br />A�OFESS i.y <br />�I�6 -sy' sf s�l <br />CONTACT l�IAME <br />C-d�Nl���� 1 <br />; ADDRESS <br />i a^dUD 71'IDiLNA�K� Jq+�l? U-j <br />S2�t-�• ww F�i� <br />puiiding M3chanical <br />PERMIT B Combination � Plumbing WORK <br />1YPE g� nkleion Si9n TVPE <br />WORK DESCRIPTION <br />�� Ci Vl a,.b P d N,� °l' �i <br />� (/ <br />N0. I TYPE OF FlX7l1RE 0 q fTEM <br />WATER CLOSET <br />enTxrue <br />LANATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK d, DISFOSAL <br />pISHWASHER <br />LAUNDRY TRAY <br />CLOTMES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PRE�IEPRER <br />SINK (SERVIGElBAR/�tOPlETC.) <br />OTHER _ <br />� b � 8'• (0 6 <br />PHONE <br />�a6-3�d�-�6�t, <br />CONTR. LICENSE+1 <br />W�Sµ tES��oGu.1 <br />I") Aadltion <br />�� Alleretion <br />4..[ Nsw <br />IJ RepsidMaint. <br />HEAT SOURCE <br />EIlctdc <br />as <br />Olher <br />CfTY OF EVERE7T LOCAL SALES TA)( COD� 16 0105 <br />�/�/a�li !� fQ 7�y <br />MECHANICAL <br />NO. � TYpE OF FlXTURE OR ITEM <br />� A/C—A/HANOLINGUNITS <br />_ FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_, UNIT FiEATERS <br />_ CLOTNES DRYER <br />RANGENOOD <br />WATER HEATER <br />METAL FIREPU\CE/STOvE <br />_ FIREPLACE INSERT <br />� GAS FIREPLACE <br />� GAS RANGE <br />_ GAS PIPtNG <br />_, EXHAUST FAN <br />_ OTHER <br />I HEREBY CERITIFY THAT I HAVE pEpD AND EXAMINED THIS APPLICATION AND KNOW ThE SAME TO BE TqUE AND CORRECT. AL1, <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS 7VPE OF WORK WILL BE COMPIIED WITN WHETHER SPECIflED NEREIN OR <br />NOT. TNE dRANTING OF A PEfiM1T DOES NOT PRESUME TO GIVE AU71iORITY TO VIOLATE OR CANCEI THH PROVISION OF ANV OTHER <br />STATE OR LOCAL lAW REGULATINO CONSTRUCTION OR TME PERFORMnNCE OF CONSTRUCTION. TMAT I AM AUTNORIZEp Bv TME <br />OWNER OF TMIS pROPERTY TG� PERFORM THE WORK FOR WHICH APPlICA770N IS MADE AND I COMPLY WITM 7HE STATE <br />CONTRAC�OR&-b1V1�38.27 RCN/ AND��B '.�0 WAC. <br />