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DEC-1-2004 14:04 FROM: 70:142525713857 P.1 <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITEADORES9 ZIOZ'00' '41 )U PARCEL TAXI.D.�U/oUO PERMIT# , <br /> LEGALt LOT NO. BLOCK TRACT <br /> D/ESSCC. , 'n <br /> 1�.V11'1 J wtQk Q ZCo 0,57e <br /> � PHONE <br /> y 5'-8 ,, ,S`l-Jc,J Zua-fell 0,:A63 <br /> TENANTNAME CONTACT FOR PERMIT PHONE <br /> qZt-7?o32dY- <br /> CONTRACTOR t /Wj C'tW� �rV ADDRESS CRY21P PHONE <br /> CONTR.LICENSE e/77Y1 VM^_� � ! ' �p�i <br /> Ldti!!'KIE.J�Q7/��CJ�-'�/ V"N' YJ <br /> USE OF I BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ST DIR-- _Electric X Gas Other I �d Z sr —' <br /> WORK DESCRIPTION / <br /> �l►�Sh-ll i�� �/11 h a-f 7�n �!Q�J Cv� /��� <br /> PLUMBING lV� MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Bathtub Forced alr systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 6 disposal Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer Clothes ge <br /> Laundry Day ry <br /> er <br /> Range hood <br /> _ Sink(s arvice/bar/mop/stc.) Exhaust fan <br /> Backflow preventor _ Heat pump <br /> _ Unnal _ Unit heater <br /> Dhnking Fountain Boller <br /> Floor drain Refrigeration <br /> trap Woodstove <br /> _ Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 710E <br /> I hereby cerilify that I have read and examined this application and know the same to be true and correcL All previsions of laws and <br /> ordinates 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 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Co tractors Law 7 RCW and 296.2 WAC. <br /> S g urs tm-.Co ntractorlAuthonq Ag /Z�/je <br />