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FROM :Ever9reen State Heat S � "� FAX N0. :425259666� Jan. 21 2009 10:53RM P1 <br /> _._ _. ...._'— _._.. <br /> PERMIT APPLICATION <br /> CITY Oh EVERETT PERMIT SERVICES � �a �-09 <br /> 3200 CEQAR STREET, EVERETT, WA 9fi201 <br /> 425-257-81310— FAX 425-257-8857—www.evorattwa.org n i d9�1 -028 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# � PEFiM1T# <br /> � � ,�� Cf,�t9l,d//Y /.��I. � <br /> LC-GAL LOT NO. BLOCK TFlACT OR SUBOIVI310N Jt <br /> OESC. <br /> WN � AUD I / p . H <br /> :7�y� Ol c,�5'e�iV �/.�i�� G,G'iov.t, D�2- Ev. �.�v 3 y.zS-3 39 - I'3 9 S <br /> TENANTNMAE � I CONTACTFORPERMIT 4HONE <br /> E-MAIL <br /> C!rL')2 G2cvti57�7� �Prad�T- :�/c l <br /> CON7R.lICENSEIt ���� P���r.G �QLC �v, l�'ZGI <br /> �-�G�o��.��- y.zs - .�s�. - 3i��/ <br /> USE OF BUILDIN� HEAT SOURCE CONTRACT PHICE OF WORK <br /> i <br /> ��/��.�� L _Etactrlc ,�as_Olher ��3dU �-.O <br /> WORK DESCRIP'lION <br /> � C✓�iA�v(c� OGfT �/G /.s�I GL� `7-D �l�"j' <br /> I <br /> I <br /> PLUMBING MECHANICAL. <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> I = Tollot A/C-air handlinp units <br /> Bufldub ^ Forcod air syslemr <br /> � Lavatory(wash hasin) _. Gac piping <br /> I ,_= Showor Woter heater <br /> Kllchan sink 8 dlsposal � Goa firopleco <br /> � Dlchwashor Ges renge <br /> � ClOthes washor _ Clalhes clryer <br /> We;nr haator � Fango hood <br /> Sink(serviceNerlmop/o1cJ Exhaust lan <br /> _ Back(low pravanler Hent pwnp <br /> Udnal Unit heater <br /> Drinklnp Foun�ain � 8oiler <br /> Floor drnln Relrigeratlon <br /> Gronse Irnp Waodstove <br /> R�ol drains Olhor __. <br /> ^ Oihor <br /> � CITY OF EVERETT LOCAL SAlES TAX CODB IS 7705 <br /> I horoby coritify that I havo road end examinod thla applkatian and krew ihe a:fine to be true and correct. All provlslons ol laws and <br /> ordlneces pouorning this type of work wlll be compliod wilh whother spocilied hewin or not. The granting ol a permit doos not prasume <br /> to plvo au�hority to vlolato or cancol lho provislon o(any olher stnto r,r locel�aw regulatlnp constructinn or the porformanco ol <br /> concVucllay�J at I flm authorized by tho owncr ol this property to oorlorm Iho work 1or whlch appUcnUon Is mode nnd I comply with the <br /> Stalo C rtfract s Law 1 7 RCW and g9�.200 WAC. <br /> � � � �� �c <br /> _�,� . .. <br /> ISi naturo of wnor/ ontractor/Aulh xod Agonl Oato <br /> I � — <br />