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OCT-15-01 NON W 21 AM EVERETT PERMIT SERVICES FAX NO, 425 257 8857 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 88201, 425.257.8810 <br />P. 02 <br />� �q5 <br />S �PA <br />CITE ADDRESS 7/i `//Z <br />PARCEL TAX I.D. 0 <br />PERMIT 0 <br />003ocr7e)o <br />D -QYC-J <br />LEGAILI LOT NO. <br />BLOCK <br />TRACT <br />DESC. 5t2- <br />j/]-CHG'jr.) <br />OWNER ,'-6) p �uLG/V.Al-� <br />ADDRESS &--;,5 <br />PHONE <br />PACI f e C'C-? /2!'S' /�/C <br />`3&A ITIC, t, c 6 i flv7 <br />I(2cv) <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />-7-"?1g,l-a'/ /tJG <br />e'-/4Q'j `i��LTZ1!J <br />I (wy) a93 -5-62 Z <br />CONTRACTORNdT St 44e-'re0 W/l <br />ADDRESS <br />CONTI LICENSE 0 <br />PHONE <br />PROPOSED USE OF BUILDING <br />L <br />PERMIT <br />Building � Mechanical <br />Combination Plumbing <br />WORK <br />Addition <br />Alteration <br />HEAT SOURCE <br />Eloctne <br />gt-TA, <br />TYPE <br />Demolition Sign <br />P <br />TYPE <br />Now <br />R4 Goe <br />F✓L3/N�r.t�J <br />Sprinkler <br />Repair/Maint <br />1, Other <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />WORKDESCRIPTION CVA,15,7t2per7- jtNiLl ,7Z/,zy 17?-^WC0 PC/9A!L <br />i� LJ/ 10 <br />jl le) (&906 >, f") , rb.0 5 fiC4-1trv! /St/h• o <br />A95JCtArl -D //'0-/� <br />PUMP <br />NO <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />AIC- A/HANDLINGUNITS <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />_ <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />,(— <br />DISHWASHER <br />LAUNDRY TMY <br />CLOTHES WASHER <br />_. <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLAC OVE <br />^_ <br />_ <br />-- <br />URINAL <br />__ <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />7- <br />FLOOR DRP.IN <br />BACKFLOWPREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER.-__..._._.___.— <br />_ _ <br />GAS RANGE <br />GASPIPING 5U/� <br />EXHAUST FAN <br />OTHER <br />t <br />1_ <br />,- <br />I HEIEBY CERITIFY THAT I HAVC RCAD AND EXAMINED THIS APPLICATION ANU KNOW I ne 5AMk 1U ae I KUL ANU wnne�,. h44 <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. TI It GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TIES PHOPFRTY TO PERFORM THE WORK FOR WI11CH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS 1: VW t j7 RCWAN?60.200 WAC <br />,o,,fr;e <br />Y3 <br />