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Oct 11 11 10:49a <br />S1TE ADDRESS � <br />Z� Z2 <br />LEGA1 LOT NO. <br />D ESC. <br />Washington Water Heaters <br />� <br />4257461563 <br />� <br />PERN�lT APPLICAT�ON <br />C1TY QF EVE#�ETT PERMIT SERV�CES <br />320{3 CEDAR ST3�EET, EVERETT, WA 98201 <br />425-257-88� 0— FAX 425-257-8857 — www.evereriwa.org <br />APPL1CA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�i �-� �'� .�- <br />BLOCK <br />; �C���l�0?/! � (1 � <br />-reNar�r Naiue � �� <br />COtJTA. U <br />lIUGiTd� wf�"��- <br />C <br />USE OF BUILDIPtG <br />�� s� d �n-idG� l <br />WORK DESCRIPTION <br />C <br />V[ia <br />I l�ARCEL TQX I.D_ # <br />60�����ssc�a� zod v <br />TRACT OR SUBDIVtSiON # <br />ADDRESS CITY21 P <br />zSzZ ��1�� �i s� ����� 9��� <br />� 0�.� <br />PLUMSING <br />TYPE OF FlXTURE OR fTEM <br />ioiieT <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposa� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/rnop/etc.) <br />Backflow preventer <br />Urinai <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NTACT F R PERMIT� pHONE <br />�1(,i. �' ��i.�i� �1..�� E-nnni U <br />A[]DR SS � <br />� 1 �(1 c�.cv- s�2�� <br />�uc de ,� <br />,���� IrLI� �Q- ��4j <br />HEAT SOURCE <br />_ EEectric _ Gas � Other <br />��� <br />NO. I <br />p.1 <br />PERMIT # <br />��,��2 �� <br />,cr��, a <br />CONTRACT PR10E �F WORK <br />� `��� <br />��:�°.� c�-� <br />TY�E OF FIXTURE OR ITEM <br />A/c;—air handling units <br />Foroed air systerns <br />Gas pipi�g <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />ReFrigerat�on <br />Woodstove <br />Other <br />CiTY OF EYERET7 LOCAL SALES TAX CODE 1S 3f OS <br />I hereby ceritify ihat 1 have read and examined this application and know the same to be true and eorrect. AII provisions ot laws and <br />ordinaces governing this type of woric will be compli�d with whether specified h�rein or not. The granting of a permit does not presume <br />Io give authority to vEolate or cancel ths provision oi any other state or local law regulating construction or the performance of <br />consiruct' That I am authorized by the owner of this prQ�erty to pertorm the work forwhich application is rnade and i consply with the <br />S1ate Cantra ors Law 78{27 RCW and 29 . 00 WAC. �1 <br />' ' � �, n ., ��-� � �,��-�/ <br />Sinnatnra nf nar!(''_nntr�Mnr/A.��h �,,,� n,.,...a ,�._._ <br />c� vu�-e- C� �� c�r� �i (� 1�o�-�t-�.c�� �r �l <br />�� <br />. <br />