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A9ay 20 10 12:03p Custom Floor Heating LLC 360-657-5014 p.1 <br /> l <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 982U'I <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S � a�-I� I <br /> SITE ADORESS PARCEL TAX I.�.R PERMIT R <br /> 3ri3 Col� �� /� Ic)or 'v`l i <br /> LCGAL LOT NO. BLOClC TRACT OR SUBDIVISION♦ ' <br /> DESC. I <br /> OWNER ADDRESS CITYZP PHONE !�/Z$=3JPS,p�= <br /> ' S , P ,�-ffr� /6�o Y -23���4�s� ��i� f,,/�4 �'ro�z <br /> iTENANTNAME I CONTACTFORPERId1T PHONE �6_3� ,�600 <br /> � �Q _ / � <br /> �.!//L-fftn J�i%.�rSTO/ EJ�WL CvS'�r..�Ia��;� f�..� <br /> � L`SNTR7� ��^ <br /> CVS�N'� T �OP f��`�/�LCC �� I �G06533570 <br /> CONTILIJCENSE�1 S/I`7 �,J�� � �� rr✓/i%Y�r. G��'{ 7p�� <br /> G�-���'h 9 P <br /> USE OF BUILDING �%-7/�� HEAT SOURCE CONTRA T PRICE OF WORK <br /> /I..1— I —Electric�Gas_Olhcr y� �OO <br /> f fY' <br /> WORK DESCRIPTION <br /> ���I2GC' � .��� <br /> PIUMBING MECHANICAL <br /> ND. NPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Tdlet NC—air handlir�g units <br /> 6atl��tub Forcod air systems <br /> Lavarory(vrash basin) _ CGas pipin� <br /> Shovier Water heater <br /> Kit�Jien sink 8 disposal _ Gas firep�xe <br /> Dislx✓asher Gas range <br /> C�c;l,os washer Clothes dryer <br /> Waler healcr Ran9e hocd <br /> Sink�servicelbaUmoplelc.) _ Exnacstian <br /> 6ar.kllow preventer _ Heat purr.p <br /> Urinal Unit hea�r <br /> _ Drinking Paunlain � Bdler <br /> Fbor drain Refngeration <br /> Grease trap _ woodstove <br /> Rcot drains ����� <br /> Olher <br /> GTY OF EYERETT LOCAL SALES 7AX CODE IS 3705 <br /> I bereby certrfy that I have read and examined Ihis application and knuw Ihe same to be true and correct All provisions cf laws ana <br /> oiVinances goveming th,s Type of work will be complietl with whether specified herein or not. 7he grarling of a permit does nol presume <br /> ;o give authaity tn vidate or nncel:he provision of any other state w bcal law regulaung constmction or ihe pedormance o` <br /> construdlon.lT;al 1 am au0iorized by Ihe owner of tNs property to perbrrr ilia wcrk lor n�hiUi application is matle and I comply with the <br /> State Ce/n�l ctors Law�8.27 RCW antl 25�.200 WAC. <br /> f�/ L �j�� .S-�d��C� <br /> '� SignaNre o� O�merlContraccoVAulhorizetl Agerl Date <br />