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JUL-11-2006 U9:33 FRON:PERNIT <br />4257756315 <br />TO:14252578857 P.1 <br />PERMIT APPLICATION <br />CITY OF EVERETT P <br />ERMIT SERVICES <br />3200 CEDAR STREET, E <br />VERETT, WA 98201 <br />425-257-8810 — F <br />425-257-8857 <br />SITE AD RE S¢ PARC <br />ZOIY r� r/_ I <br />L TAX I.D. # PERMIT# <br />V Cl(�tJ P- <br />1366 zo � 2,0() <br />LEGA LOTNO. BLOCK TRACT <br />DESC. <br />OWNER <br />ADDRESS <br />h rncl2�rr�;er- z� 9 `ffs <br />ZIPf3o <br />�uv�L f�zoS! Pas 3 <br />TENANT NAME CONTACT FOR P PERMIT <br />1l c [V 12 <br />/� <br />PHONE <br />CONTR CTOR C� ,-, `_� n_��� f r ADDRESS <br />(.iJ �f � Zl"UL/ �({ Cam./ <br />21P CONTR. LICENSE # <br />JQ <br />PHONE <br />2.o& z$L 76o <br />PROPOSED USE OF OUILDINGBuilding <br />T <br />Mechanical Addlllon HE T SOURCEMIT <br />rIH-}( COmbinOtlon <br />Oemolillon <br />lunlbing WORK �AlleretionElecUlcE <br />Slgn TYPE <br />Sprinkler <br />Now One <br />Repah/Malnl. Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 310S <br />CONTRACT PRICE OF WORK *7 .3 <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />A/C—A/HANDLING UNITS <br />LAVATOR_ <br />SHOWERY (WASH BASIN) <br />FORCED AIR!'YSTEMS <br />HEAT PUMP <br />_ KITCHEN SINK & DISPOSAL <br />_ DISHWASHER <br />UNIT HEATERS <br />CLHES DRYER <br />]�RAONGE <br />LAUNDRY TRAY <br />HOOD <br />_ CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />METAL FIREPLACE/STOVE <br />DRINKING FOUNTAIN <br />_ FIREPLACE INSERT <br />FLOOR DRAIN <br />_ GAS FIREPLACE <br />_ BACKFLOW PREVENTER <br />_ GAS RANGE <br />__ SINK (SERVICE/Bp,R/MOP/ETC.) <br />OTHER <br />GAS PIPING <br />EXHAUST FAN <br />_ OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION <br />PROVISIONS OF LAWS AND URIUINACES GOVERNING THIS TYPE OF WOR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOF <br />NO KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />ITY <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORM0 <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR <br />TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />CE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />WHICH APPLICATION <br />CAat <br />IS MADE AND I COMPLY WITH THE STATE <br />So Owner/Contractor/A n.e gent <br />1e <br />DEBIT & CREDIT CARDS AF <br />E NOT ACCEPTED <br />