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01/04/2006 16:21 <br />5036566383 PORTLANDMECHANICAL PAGE 01/01 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9B201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />"k12 SAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 4�1 r) <br />SITE ADDREss <br />LEGAL LOT NO. I pLOCh <br />TRACT <br />PARCEL TAX LD. R <br />PERMIT M <br />Ell TYZP PHONEI <br />� �' A/ fS2rz.�1rm 97 So; -797-7 S� <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />CONTRACTOR L�ir+d Kj/i9jl/K/�L. ADDRESS crrymp PHONE <br />P417�1S <br />CONTR. LICENa! a 2,,.,,,, '" <br />�1- xwA�//A2 /4Tll� Nlu✓gcc tiE� OX 9722Z <br />USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric Gas Other of - i000. — e <br />WORK DESCRIPTION <br />RC�Gh &>e1Sr1A4 REr11K/`CfFli�1� iXZn�t✓ /A/ 73`r DEL! J B�rrey <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 6 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service bar/mopletc.) <br />Backfiow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Root drains <br />Other _ <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ A/C —air handling units <br />Forced air systems <br />_ Gas piping <br />Water heater <br />Gas fireplace <br />Gas rango <br />_ Clothes dryer <br />Range hood <br />Exhaust fan <br />_ Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />_ Wcodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3t05 <br />I hereby ceritlfy that I have read and examined this application and know the same to be true and correct, All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give a4crity to violate or cancel the prevision or eny other state or local law regulating construction 'or the performance of <br />construe. That 1 am a{ethOrka by the owner of this property to perform the work for which application is made and I comply with the <br />state Co6t cmrs Law/6tZjj RC and 296.200 WAC. <br />ZIM <br />