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Nov 21 11 11 '�9a Weshinplon Weter Heelers 4257461563 P.1 <br /> � �. . �Jo� <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 /> �t f a-� I/ <br /> APPUCAT70N8 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS` PARCEL TAX t.D.il PERAI�T R <br /> ' � S � � � — <br /> LEOA l0T NO. BLOCK TRACT OR BUBDIV1810N� . <br /> DESC. � <br /> Ep ADU 21P PMON�— <br /> 7�N G 1 P� aiar� c�����r�� Sr. �*� Ev�,-.��g��o� yas �6ao^�a—r���3 <br /> 7EN1WT E �ACTF HPEflNfT� PHOfE IIO� 7 ' ✓J6 <br /> N�� I�1ClCCl �Gi.YiI��S E-�a�.ho�u�affd'`� rtu� a!I ,a <br /> �oW�6 iNG,TOrJ N��rE2.t�/'�� ��,c k�a'' S &'�K <br /> r,u�t5 � 9S� oP _ P�ellcvuL lUQ 9�05 <br /> USE OF BUILDIN6 HEAT SOURCE CANTRACT PRICE OF WORK <br /> r,eside�,-#�ra.. I I �.eia�� _a�_an� ( �.�y � <br /> WORK DESCRIPTION <br /> C f na � a-u:� I � �.���r,� c�a:-I�.� �a� � <br /> PLU BING MECHANICAL <br /> NO. TYPE OF FlXTURE OH ITEM NO. � TYPE OF FIXTURE OR fiEM <br /> Toilet A/C—air liandlinp unks <br /> Uathtub Forced air syslema <br /> _ Luvatory(wash basin) _ �es P�P��B <br /> Showor Weterheaier • <br /> Kitchen eink&dlsposal _ Gas Iirepiece <br /> Dishwasher Gas renqe <br /> Clothes washor _ Clolhes dryer <br /> = Water heater _ Range hood <br /> 5(nk(aeMce/berlmop/atc.� _ Exhaust fan <br /> Backtluw preventer _ Heat pump <br /> Udnal Unit healer <br /> Drinking Fountaln . _ Boller <br /> Floordrain _ Fiefriperatlon <br /> Orease lrap . _ Woadstove <br /> Roof drsfis Other <br /> Olher <br /> CRY OF EVERETT LOCAL SALES TAIf COOE IS 3106 <br /> I hert+by cedUly Ihal I have reatl and examined lhts epplicaUon an0 know the s�ne to be We and cortect. All prc��talons of!aws and <br /> ordlnacos govemfnA this type ol work w1l be mmpiiad vdth whether apecl0ed harein or not.The pranUnp ol e permit does not presume <br /> lo pive autlwrlty to Wolate or cancel the provklon of any other etate or lowl law rQpWaU�oonetructlon or tho performenoe of <br /> conetruclion.That 1 am eWhorfzed by the owner ot this pmperty to peAorm tha vrork tor whtch appllcaUon Is made end I compty with the <br /> Stal�W 18.27 RCW 2862 WAC. ��i �r�� . <br /> � // / <br /> l..(A f <br /> igna o ner/ on:ra r ul adApent ete <br /> �QG;�Q Ll�- 0� IV1�'D � C�b7�I�C'�'lJI��Ql� ��rh�' � C01'�h� <br /> �hUMK-� . <br />