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JUL-17-02 WED 02�56 Pn EVERET1' PERflIT SERVICES FAX N0, 425 257 8857 P, 02/02 <br /> ------— , <br /> PtRMIT APPLICATI�N <br /> � CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> i 425-257•8810—FAX 425-257-8857 <br /> � L�7'QJ'Z <br /> i , <br /> ISITE ADDRESS PARCEL TAX I.D.N PER 1 �Y <br /> •3oc� 1 0�9k�S �d�E. <br /> ItEGA LOTNO. 6LOCK TRACT <br /> OESC. <br /> i OWNEq <br /> ADUR SS LP PHONB <br /> ��hIoN�M rs N wvNr'Y <br /> � TENAN7NAME CONTACTNAME pHONE <br /> c��RREcn�Ns-wa2K k��EAS�I R�aiN H,B�es �Q5-3��-3��2. <br /> I CONTpACTOR AOORESS IJP CONTR.LICENSlR <br /> i UN/dEi1t/TY M� Cf/.�Nic,�L ll6/l '!��N l�/ W f(3275 uN�l� � * 343 N 9 <br /> � PHONE �I/�Uk/LTF��� �✓� <br /> � <br /> PROPOSE�USE OR BUILDINO fl,8uilding Mechenical f7 _ndd���on HEAT SOURCE <br /> PERMIT �� Combination Plumbing WORK �yAllera��on fa'S Elaetric <br /> � wo�cc �Z����s.�' K 1=< K <br /> 7YPE �_� Deinolilion Sign TYPE �__� Naw �_� Ges <br /> � �Q��,ea,� r{,�srotN� � Sprinklar U Rep��r;rnai�i. LJ Other <br /> I CONTRACT PAICE OF WORI�S��U CITY OF EVEFETT LOCAL SALES TAX COOE IS 3705 <br /> R <br /> ! WORK DESCRIPTION <br /> j I3,E�wUi�E� /NTkK/OiZ �'aRTio�� oF �AiV Ex�sri.n�G 6v�cJii�(� <br /> � <br /> i <br /> I PLUM9ING MECHANICAL <br /> I N0. TYPE OR FlXTURE OR REM NO. I TYPE OR FlXTUR!OR ITEM <br /> � �, WATERCLQSET _ NC—A/HANDLINGUNITS <br /> FORCED AIR SYSTEMS I <br /> i � BAVA'ORY �WASH OASIN) � HEAT PUMP I <br /> SFIOWER _ UNIT HEATERS <br /> ; _J._ KITCHEN SINK 8 DISPOSAL CIOTHES DRYER <br /> i ` DfSHWASHEA ^ RANGE HOOD <br /> � W:INURY TRAY _. WATER HEATER <br /> ' � CLOTHES WASHER META�FIREPLACFJSTOVE <br /> � UFiNAL � FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> � FLOOR ORAIN _ 6AS RANGE <br /> B�ChFLOW PREVEN7ER GAS PIPING <br /> � � SINK(SERVICE'BARIMOP/ETC.) _ EXHAUST FAN <br /> � OTNER_ = OTHER I <br /> �I . I <br /> �HEHEBY CEnITIFY TNAT I HAVE READ AND E%AMINED THIS APPUCATION ANO KNOW TNE SAb1E TO BE TRUki AND CORRECT. ALl I <br /> PFCVIStOtiS OF NWS�ND OP,IDINACES GOVEqNING THIS TVPE OF WOHK WILL BE COMPLIED WITH WMETHIF SPECIFIED HEREIN OFi <br /> NOT, THc GN?hTING Uf•A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE PN CA�vCEL TT1E PROVISION OF ANY OTHER <br /> S7A7e OR LOCAI LAW REGULATING CGNSTRUCTION OR TNE PERFORMANCE OF CONSTFUCTICN. THAT I AM AUTHOR2ED 9Y TME I <br /> OtY�cR OF 71iIS P OPERN TO f ERFORM THE WORK FCR WHICH APPLICATION IS MADE ANO I;,OMPLY WITH THE STATE I <br /> CCNTNACT�CFS W i8.21 HC4V AND 23fi.2C0 W\AC. <br /> . � / � . `�. �� <br /> � <br /> . S�gnawre ol Uw U ntractoqAuthonzcd Agenl a�o <br />