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From: IbIAC INC. To:914252578857 04/"1 2011 01:34 #597 P.0021003 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettw,t.or0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT A i <br />�6 7/ S �' � <br />/7,((i <br />LEGA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION 1 <br />DESC. <br />OWNER ADDRESS CrTyIzlP PHONE <br />27/S /5"1'.PAV . CVec . //ZS-3c73-1/s� <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />/ '4 <br />I <br />�E-MAILL <br />ADDRESS SUL1i IJ4''y T rZ1zP PHONE <br />�(oO <br />,,4/ <br />CONTR.LICENSEA /tii�1-ez B!1 SOL/%7¢, fgj %"`0 4)17 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />I <br />✓Electric ✓Gas_Other <br />I <br />WORK DESCRIPTION //,{�'�ta-�L YJ'P�r--) C r r s;<i/r��C�l-�' ,PCOVI � <br />aC[, sky-t Jt�s (S crf �J) cvPy O)L• SEuPE vfi wo.tz,C- UPtu� g a) <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR REM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C— air handling units <br />! <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink (servlce/bar/mop/olc.) <br />_ <br />Exhaust Ian <br />_ <br />Backflow proventer <br />_ <br />Heal pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boller <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />WDodslove <br />_ <br />Root drains <br />Other _ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know Ilia 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 authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors - w jtCW and 296.200 WAC. <br />C-- <br />Sign tun o OwneVContractodAutForized Agent Date <br />