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JUN-04-2008 09:54 From:PSF MEC CAL 2067628381 TH.4252578857 Paee:2'2 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evorottwa.org <br /> c7- APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# R T# <br /> 3(203 w CAS 1rio 2804i 000 o .00 ap -oC')- <br /> LEGAII LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> WNER ADDRESS CITY/ZIP PHONE <br /> 126 nl 5eicr{te_.TENANT NAM UTFOR PERMIT PHONE O() 9D I . 0640 <br /> � "LaA 0 I yaw E-MAiLD Ai i, . 14 'orYk <br /> CON mti <br /> - raet,hr�:►Akca,� °1322 I $ S Wyk_ .1D1D1- (2o0'1(01- _' t,b5 <br /> CONTR.LICENSE# <br /> 'R le me 01OJN‘z.. <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric .. Gas_Other $ oDel.°° <br /> I <br /> WORK DESCRIPTION I • <br /> n5 }i JI IC` tottic 1()Y , "- <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> --r— Kitchen sink&-diepeeel Gas fireplace <br /> Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> — Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Host pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> __ Floor drain Refrigeration <br /> Grease trap _ woodstove <br /> Root drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and knew the same to be true and correct. All provisions of laws and <br /> ordinaces governing this typo of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> St• 1,• ■ tractors Law 18.27 RCW and 296.200 WAC. I�j <br /> Sig!/r (ak1c <br /> ' ure of Owner/Contractor/Authorized Agent Date <br />