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JUL-27-2003 12:36 PM STATE.MECHANICAL.CO P.04 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425.257-8810 - FAX 425.257.8857 <br />SITE ADDRESS PARCEL TAX I.D. P J I PERMIT- <br />LEaAd LOT NO. I BLOCK I TRACT <br />OWNER ADDRESS ZIP PMUNIL <br />sGur.J C.y1'�'vfrc� S. ZU inE� FN Age �Iir <br />I TENANTNAME I CONTACT NAME PHONE <br />I CONTRACTOR ST4'-rr ADDRESS root l,. J..'.I J.' �' ZIP CONTR. UCCNSE0 <br />I <br />i 'leis& SI AT400t&k4t�� <br />/tom) s7S-7�Z? <br />PROPOSED USE OF BUILDING <br />C M Y e • 1 <br />PERMIT LR.( <br />TYPE LJ <br />l] <br />Building <br />Combination <br />Demolition <br />Sprinkler <br />Mechnnicol <br />Plurnb ng <br />Sign <br />WORK <br />TYPE <br />AWItion <br />Alteration <br />New <br />RepedMaml <br />HEAT SOURCE <br />R Electric <br />(„j 008 <br />CUer <br />CONTRACT PRICE OF WORK 9/lr-. <br />CITY OF EVERETT LOCAL SALES TAX CODE IB 3106 <br />WORK DESCRIPTION <br />f <br />rz" .4f r <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR REM <br />_ <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />SACKFLOW PREVENTER <br />SINK (SERVICEIBARIMOP.'ETC.) <br />OTHER WATIT "."•tt _. <br />_ <br />„ <br />I AIC - A(HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />OAS PIPING <br />EXHAUST FAN <br />OTHER______ _ <br />_ <br />_ <br />_ <br />_ <br />_ <br />— <br />_ <br />y <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATICN AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMF. TO DIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCH TING CONSTRUCTION OR THE PERFORMANCE OF CONS I PUC TION. THAT I AM AUTHORIZED BY THE <br />OWNER OPERTY O PF.PFOPM THE WORK FOR WHICH APPLICATION iS MADE AND I COMPLY WITH THE STATE <br />CONTR JS 2711CW AND 296200 WAC. <br />7- z_/ 0S- <br />