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425-252-1666 CM HEATING 08:24:08 a.m. 07-22-2014 3/3 <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> Z2O\ \1+ir911 O Pcv 6) 118201 1 I Mly07 - C3 <br /> LEGALF LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> ?ekh 64.1 lag h€r 5g53'S`r tela Si- , •Laaup©o.. CA 90713-.1(56z gov 3739 <br /> TENANT NAME CONTACTIOR PERMIT PHONE 425 299.GL.jo <br /> b .bite E.MAi ebbie@Cm haci -CM <br /> .c <br /> CONTRACTOR •D-ESS CITY/ZIP CITY/ PHONE <br /> CMHea1rlq Inc `4I 5 �'i ��roodwati Q$2oi [4725R(o66� <br /> CONTR1LICENSE Sy7F oq 5RL <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Electric Gas_Other <br /> 304°% <br /> WORK DESCRIPTION <br /> elyloma. S(A,S - rrteic_.. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet NC—air handling units <br /> Bathtub 1 Forced air systems—gets fv r mx-c.2i <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal 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 Heat pump <br /> Urinal <br /> Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap <br /> Roof drainOOtherrstove <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type 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 /> State Contractors Law 18.27 RCW and 296.200 WAC. 1 <br /> 7 22.l' <br /> Signatu of Owner/Co actor/Authof�i3��Agent Date <br />