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FROM :Evergreen State Heat & A' FRX N0. :4252596660 � Dec. 28 2009 09:07RM P1 <br />l <br />y <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAFi STREET, EVERET7. WA 98207 <br />425-257•8810 — FAX 425-257-8857 — www.everettwa.ore <br />APPLICATIONS ARE ACCBPTED FROM 8 AAA TO 4 PM <br />81TE ADpRE86 PAqCE4 TAX I�D. il PERMIT M <br />33�3 �'s�o�-L ,o� � ��� � r��!t <br />LOT H0. <br />cAv.e¢ 33i <br />CONTACT fOq pERMR <br />0 <br />�:�ry711wcluM wt+uncoa 6iniur rpunc <br />E�c6a�e. c.�. s,yse.�--�,.a�vc <br />CON7N. l.l0EH8E N . .. . %,I T V �14o/FJ� A� a : �fa?O � %3.Z �-3��Y <br />6Lb2G JS/ ?.2oT' <br />USE OF BUILDINO <br />/��/�� <br />NEAT SOURCE I CONTRACT PRICE OF WORK <br />J <br />,�Elaclric _Ges_Other Jr� ��� p <br />WORK DESCFiIPTION <br />�W�rlar[L O^t �7'�Ge�SS 1i��lll� �M.O <br />N0. � <br />TYPE OF FIXTURE OR REtd <br />_ Toile� <br />Bathtub <br />_ Wvatory (wash bosin) <br />__ Showor <br />� Klichen slnk & dleposal <br />_ Dlshwnshef <br />Clolhes wesher <br />Walor haater <br />._._. Slnk (service/ber/mop/etc.) <br />6ackflow provonlor <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Groaso trap <br />Roof drnlns <br />Olher _ <br />N0. I TYPE OF fDfTURB Oq REM <br />� � — �Ir handlinp unlls <br />_, . Forced alr systems <br />Gas piping <br />Wet9r heater <br />_ Gas Iiraplace <br />Gqc range <br />„ Glothes dryer <br />_ Ranpehood <br />Exhaust len <br />Z Heat pump <br />,_ Unitheator <br />_ B011or <br />_ Ralrlgoration <br />Woodctove <br />_ Other ____ <br />CRY OF EVERETT LOCAL SALES TA%CODE 19 7106 <br />I horeby cerili(y that I have read and oxeminod this applicalion end know Ihe same to bo Irue and cnrrea. All provisions of lews end <br />ordinaces govorniny Ihis lype of work will ha complled with whalher spocllled horCin or not. The prnntlnp ol d pormit does not presume <br />to plve authorily to vlolnte or cancel the provlslon ol any other statu or local law rapulntinp conctruction or the peAormance of <br />constn�cf' at I nm aulhoriaud by Iho ownor o( th�a property to perform the work lor which appllcation ie made end I comply with the <br />Stet ontrac rs Lew 18.27 RCW end 296.200 WAC. <br />