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frnm: 01/18/2007 07;55 p252 P.002/006 <br /> PERMIT APPLICATION 35�,°" <br /> ��� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-f3810 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITA <br /> dU' IUy I'I. 51:, I;Vflil:"I'T. WA 9R20N 00761G00001200 <br /> - .i' �_ � - �. •" � <br /> LEGAL LOT NO. BIOCK TRACT <br /> OWNER ADDRESS � PHONE <br /> ��oz i o�� ri. si'- <br /> A('COILD.JA�1f.S R SHGItI'L (d25)755-5778 <br /> • I:Vl:ldli'f7�, N'A 9ffi08 <br /> TENANT NAME CONTACT NAME PHONE <br /> Nmnclallill 800 d5.!-R9tS�l3i <br /> CONTRACTOR AODRESS CONTR.LICENSE# <br /> I Ati�l��4'A7'I:R IILA-ff:R ('UMPANI' 1�601 13?NU AVG NI: ��qs1���'N'H7JRliC <br /> _HON E <br /> (425)BI�1-117.4 KIRKi.ANU, WA 9R034 OIr031200R <br /> PROPOSED USE OF BUILDINO Bulldinp M�ehenlpe WORK Addlllon N T SOURCE <br /> PERMIT Com6lnttlon ' Plumbin /Ul�ntlon EIec�Ao <br /> 7YPE Damolilion Biqn TYPE New as <br /> � Re elrlMalnl thor <br /> CONTRACT PRICE OF WORK S9q9.p0 l'ITY OF EVERETT LOCAL SALES TA7( CODEIS 7105 <br /> WORH DESCRIPTION <br /> Hcmove'RC(ll8lt I:IL'Clfll WlllCf IIC81Cf <br /> PI.UMBING MECHANICAL <br /> TYP UF FIXTU OR I E OF F 11RE OR ITEM <br /> _. �._ .__ WATER CLOSET __._____ A/GA/HANDLING UNITS <br /> . ._ . .. BATNTUB _____ FORCED AIR SYSTEMS <br /> _____ LAVATORY (WASH BASIN) _____ HEAT PUMP <br /> ____ SHOWER ___ __ UNIT HEATERS <br /> ___ KITCHEN SINK 8 OISPOSAL ______ CL0IHES �RYER <br /> _____ OISHWASMER _ _ RANGE HOOD �, <br /> ______ LAUNDRYTRAV ._ ��___ WAIERHEATER � <br /> ____ CLOTHES WASHER ____ ME7AL FIREPLACEISTOVE <br /> __ URINAL ______ FIREPLACE INSERT � <br /> __ DRINKING FOUNTAIN ____ OA3 FlREPLACE <br />� __. FLOOR DRAIN ____ OAS RAN6E <br /> _. _ BACKFLOW PREVENTER „_,___ GAS PIPIN6 <br /> ___ SINK (SERVICE/BAR/MOP/ETC.) ^�_ EXHAUST FAN <br /> ----- OTHER--- --- --�-- OTHER--�•---�------------------ <br /> 1 NERFBY C[RTIfY iHAT I MAVE READ AND EXAMINED THIS AP'.IC�TION AND KNOW T1E SAME TO BE TRUE AND CORRECT ALL I <br /> PROVISIOMS OF LAWS ANU URDINANCES GOVERNIN(3 THIS TYPE OP WORK WI'�L BE COMPUED WIHT WNETHER SPECIFIED MEREI <br /> OR NOT. THE OHA11T1N3 OP A PERMIT DOES N01 PRESUME TO aNE AUTHORITV TO VIOLATE OR CANCEL THF PROVISION OF ANV . <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION pR THE PERFORMANCE OF COhSTRUCTION.THAi I AMAUTMORIZE� � <br /> BY THE OWN[R OF T'+IS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICAiIUN IS MADF AND 1 COMPLV WITH THE ST�TE I <br /> CONTRACTOR6 LAW 78.27 RCW AND 208.200 WAC 'I <br /> SlgneWra of OwnadContreelor/Au�horized Agem ��. ,_ ��,,—�_�:. Dats �I;I B"007 <br /> ui.ai <br />