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Apr 11 12 10:35a Washington l'Vater Heaters 42574F 1563 P � <br /> PERMIT APPLICATiON <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT�,WA 96201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (,/._,��—/?i <br /> SITE ADDRESS ' PAflCEL TAX I.D.# PERMIT# <br /> as � s� -d o �o -�� s <br /> LEGA LOTNO. BLOCK TRACTORSUBOIVISIONa <br /> OESC. <br /> OWNEN ADDRESS GTY21P PFiONE <br /> as � - = Q.re.lr� 9 0/ `/'�s• as-9-7 3E <br /> TENANT�1fUAE . ACTF�( PERMIT� PHONE (��—y��� � <br /> � li 4. '}' / I QCG �f.JGU7l��S e-Ha�OfWQ,�/�y OZC� Q�1 <br /> CDNTA.LI E,NSE f' V� lUi ITG/�-���AD � Ow� Tl-/7� s C W'�g ��' <br /> ��tsr-F-r�� �� �P /�e.ucvue I.UQ 9S'�a5 � <br /> USE OF BUILDInG HEAT SOUflCE CONTRACT PRICE OF WORK <br /> �'�sl d�n�l'(Gt- l I �E�ectric ,_Gas_Other I ����� <br /> WORK DESCRIPTION I^ ^ <br /> C �l(A,� �. Q�(_,�' ( � /-�r,'� (�GL� I" U� a,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. ZYPE OF Fl%TURE OR ITEN <br /> Toilel � A/C—airhandlinguMts " <br /> Oathlub Forced air syslems <br /> Lavafory(wash basin) Gas piping <br /> � Showcr Wator heater • <br /> Kitchen sirJe&deposal Gas tireplaco <br /> Dishwashcr Gas range <br /> Clothos washer Clothes dryer <br /> _L Watcr hea�er Range hood <br /> Sink(service/badmop/etc.) _ Exhaust tan <br /> Lackflow preventer Heat pump <br /> Urinal Uni�hcater <br /> Drinhfng Founl¢in Boiler <br /> Floor drain Relrl�eratlon <br /> Grease Irap Woodstave <br /> Aool drains OUicr <br /> Other <br /> � CITY OF EYERETT LOCAL SALESTA%CODC IS 9105 <br /> 1 h¢reby cerility that I have read and examined this applica6on and know the same to be iruc and correct All provislons of laws and <br /> oMlnaces goveming this type of work v�ill be complied with whelher spcalied herein or not.Tlie granting ai a permil does rmt presume <br /> to give aulhority lo�tiolate or cancel the provision ol any ather state or lowl law reguiating construction or the pertormanco ot <br /> construclion.Thal I am aulhorizod by ihe owner ol this properly lo pedorm ihe vrork lor which application is made and�cvmply with the <br /> State Contmcrors Law 1827 RCW and 296200 WAC. �j ��� <br /> t'�'L'�i'�`�// ��) ��^ �� � ��- YU'1:;:1i-'�4uli::.t.�l CY �•t'rJc:��i,,j '�1 <br /> Sic�nuNre oi Owner/Con�ractor/Au borized Agent Dalo ���'���� �"{�'�'� <br /> �►�i� u�e- � tv� c>��i�C �i�- �cm-t�c(v�ti-Ir�1���1�►`i�u� -�� Co�r� <br /> -ri�ctiv���l . <br />