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JUN-19-02 14:24 FROIMNORTHkE°' r.ASSIMAR 206-374-09V T-127 P 01/01 F-234 <br />CHIVIII APPLICAI.ON <br />I.� <br />CITY OF EVERETT PERMIT SERVICESI <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257.881P. <br />SITE ADDRE6 PARCEL TAX 1.0. N I PERMIT N <br />1 T A 5+- _98 z0--1 rootAS-zS o 00 00 V ; -U26,, <br />LEGAL L TNO, BLOCK TRACT <br />DESC. ' <br />OWNER ADDRESS ' <br />PHONE <br />TENANT NA CONTACT NAME PHONE <br />LtgNl%lLL GA-(,L �%Ab-3%Q�lnb'817 <br />CONTRACTOR S C 4� ADDRESS <br />CONTR. LICENSE M <br />PHONE ' a$?JO 7Nc� AJAyJ=E � VJ WWI E S4"7 0 e vi <br />rh 5� L/7&o SE'a4fj 1Aj 0 k F 1 <br />PROPOSED USE OF BUILDING Building Q� MOchenical Adflio HEAT SOURCE <br />PERMIT P <br />Combinatlon [D} Plumbing WORK;R�eir)Malnl. <br />AlWnTYPE Domolltlon Sign TYPENIE¢ Gas <br />Spdnklar L J Other <br />CONTRACT PRICE OF WORK CITY OF EVERETT LOCA SA E8 TAX CODE 18 2105 <br />WORK DESCRI N <br />MECHANICAL <br />NO., Ty OF FIXTURE OR TEM NO. TYPE OF FIXTURE DR ItEM <br />WATE CLOSET A/C - AMANDLING U IT'$ <br />BATH B = FORCED AIR SYSTE 8 <br />LAVA RV (WASH BASIN) HEAT PUMP <br />SHOW I i UNIT HEATERS <br />KITCH N SINK 8 DISPO SAL CLOTHES DRYER <br />_T DISH BHER RANGE HOOD I I <br />IAUN AY TRAY _ WATER HEATER <br />CLOT ES WASHER RINA _ METAL FIREPLACE/STCyE <br />D_ FIREPLACE INSERT I <br />DRINK NG FOUNTAIN GAS FIREPLACE <br />FLOG DRAIN — GAS RANGE <br />BACKF LOW PREVENTEH GAS PIPING <br />"- SINK (I iERVICE/BAR/Mo'IETC.) — EXHAUST FAN <br />OTHE OTHER- <br />-I HEREBY DER TIFY THAT I HAVE F1W- AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS FLAWS AND ORMINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE O NTING OF A PERMI r DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL T'HE gAOVISION OF ANY OTHER <br />STATE OR LO AL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I Alrl AUTHORIZED BY THE <br />OWNER OF S PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WIT�1 THE STATE <br />CONTRACI 27 RCW AlD 0 WAC. <br />SI o.o "e It ctor/ I thcrized Agent to <br />U I.-.0 15sa - ,, �71- ��R -IZ�$-- <br />