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� rnr. <br />0710�'20'1 12:13 �70U P.0021003 <br />PERMIT APF'LICATIO(v <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-881� <br />A7.5-257-8857 FAX <br />�r r.� ST SW. GVL'IL}�I'I', WA Y8'_0? <br />OWNER <br />1��LI.IPPIi. DONNA <br />TENANT <br />CONTRACTOR <br />I-:1tiT R'.4�ff=.H 111{A7'IiH CU�fI'ANY <br />P_tiONE az5-sss-�o�'4 <br />PROPOSED USE OF BU <br />Residenlial <br />�RCEL TAX I.D.# <br />u0571400000200 <br />ADDRESS <br />tb9 74 S7� SN <br />� li\'IiRI•:I"I�, \VA 9R203 <br />coNTacr N� <br />ADDRESS ' <br />1'_6U1 13.'.NII AVI; NP- <br />KIIiKLANU, At'A 9RU3•1 <br />Bulldinp M�ch�nlca WQRK <br />PERMIT Com6lnellon � Plumbin0 TYPE <br />r(pE Damolllion Slpn <br />WORK DESCRIPTION �icmo��clicpl;�tr, fJccvic 11'ntcr 1lratcr <br />WATER CLOSET <br />BATNTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISNWASHER <br />UIUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />OR�NKING FOUNTAIN <br />FLOOR DRAIN <br />BAC{:'r1.0Y1 PREVENTER <br />SINK (SERVICFJBAR/MOPIETC.) <br />O7MER —_—.----- <br />CITY OF <br />547829 <br />—%— �� <br />,17 <br />PHONE <br />(J'S)30R-fil_'G <br />PHONE <br />nzs-�sc-�og�� <br />CONTR.LICENSE# <br />PAST1V11'119�IR13C <br />01 � U3/3012 <br />AI leration <br />N�w <br />SALES TAX CODE15 7105 <br />A1C-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE NOOD <br />WATER HEATER <br />METAL FIREPUICE/STOVL <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />E%fiAUST FAN <br />O TH E R _--------------------- <br />-- _I -- � — — T - I .----_I- ` ------ -----^--------- <br />1 NE FtFl3Y G[RTIFY TIU1T I HAVE R[AD FNp EXl�MINED THIS AF>LICATION AAO KNOW TH[ SAME TO DE THllt AND CORRECT ALl <br />1 OVISIONS OF LAWS l�NU ORDIN/�NCES GOV[RNING THIS TVPE OF WORK WIIL BE COMPUEU W�HT WMETNFR SPECIFIED NEHEII <br />G�. NOi. THE GWINTINI.i UF A PCRMIT DOESNOT PR[SUME TO GIVG AUTNORITV 10 VIOLATE OW CANCEI TNE PROVISION OF ANY <br />OTNER 57l�TE OR LOCAL LAW RECiULATINGCONSTRUCTION OR THE PERFORMANCE OF CUNSTRUCTION. THAT I AM AUiMORIZED <br />py THE UWNGR OF �HIS PROPEHTY TO PERPORM THE WORK FOR WHICN APPLICA '�N IS MAOE AND I COMPLV WITM TIIE STA1E <br />CON7RACTORS ll�W 1B 27 HCW ANU 298 200 WAC. <br />ro of OwnodContrectorlAuthorizod Agon1 , lt�l� <br />D�te 117i072011 <br />