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Oct 30 2009 8: 04RM West Seattle Furnace 206 935-0735 p. 3 <br /> f <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—vwvw.everettwa.org <br /> APpLICATIONS ARE ACCEPTED FROM 9 AM TO 4 PM �� .�3 O —U� <br /> SITE ADDRESS PARCEL TAX I.�.A I P RMIT N �. <br /> � l�tr� r O L,��9/D'�`'2 <br /> LEGA LOT N0. BLOCK TRACT OR 9UBdVI810N R <br /> OESC. <br /> OWNEfl AO RESS Cm�P ��� <br /> � 5 • 5 � 1 � <br /> TENANT NAME COHTACT FOR PEPMT PH� a o� a� a �q o <br /> �iK�YY`.l-C. W -MAIL <br /> �ir-�..r�,v�a.n ' ►'�q ' rq , i <br /> ��-"�-u,.r��.ibQ�-1iZ.A �1too1 S 1'��!-1� PL Con.l��-� W0., q alln 8 aotn � '��IS• <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I �Electrlc _G2s`Olher , 3 � b� � <br /> WORK DESCRIPTION <br /> � n ga�.�� a . 5 �� -� P� �'-�P <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF R%TURE OR REFI <br /> Tollet FVC—air handling urits <br /> Bathtub Fo rced alr systems <br /> Lnvatory(wash basin) _ Gas piping <br /> Shower Wetor heater <br /> KRchen sink 6 disposal _ Gas fireplaca <br /> Dishwasher _ Gas range <br /> Clathes washcr Clolhes drycr <br /> Walor heator Ranpe hood <br /> Sink(serviceR�ar/moplelc.) Ezhaust fan � <br /> Backflow provonter �_ Heat pump <br /> Urinal _ Unit healer <br /> Drinkirg Fountain _ 9oiior <br /> Fbor drefn RofriSeratlon <br /> Greasa lrap _ Woodstove <br /> Root dralns Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE 19]106 <br /> I hereby cedtify thnt I havo road and axnmined this applwatbn snd know the same to ba U�.e and carract. All provislons of laws and <br /> o•dinacos govoming this type of work wlll be compiled with whe;her spacitiod heroin or not Tho prantirg ot e pettnit does not presume <br /> to give authoriry lo Woiato or cancel tho provlsion of any other state or bcal law regulating.;onstruclion ar iha parformanca ot <br /> cons' cllon.That I am authorized by thc ownor of thls proporty to pertorm tho work for whkh eppllceUon is made and I compty with lhe <br /> St ,e ontraaors Law 78.27 R , and 296200 WAC. <br /> � w � af 3�109 <br /> wre ot OwnerlConlraclodAuthonzetl Apant a�o— <br />