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Jul 21 2010 10: 28FM FDAMSPLUMHING 360-691 -1382 p. 2 <br /> � ' <br /> PERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-6810– FAX 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AD�RE33 AARCEL TAX I.D.i! RMIT� <br /> p 003� � lCY�� - OOI <br /> LEGAL LOT N . BLOCK TRACT OR SUBDfYI�lON Y <br /> DESC. <br /> OWNER ADDRE83 CITY2IP i�HONE <br /> k�r �.�v�� t�wdl � 2� 1 Mac���oll� �vt Ev.r.rr.-t�- �3 <br /> TENANTNAME CON7ACT ORPERMIT PHONE 3LW lG�1-2153 <br /> I �(�lliY�C P�UhT�biri6�4 '`1YC �'LJY� e•Ma�IHmP�����.�.,�y u.mlavtn�ric• <br /> c Nr croR ms P�uxnb����,hrt syc.�� c�Trrziv—PAaA�""'`—� <br /> CONTR.LICENE'c/ aDRNlS1�F�IV�OS PO FA� llo"I7 MA.iySvilF� q�iLlO 3u4-lF��t•2153 <br /> USE OF BUILDIN6 I HEAT SOURCE LONTRACT PRICE OF WORK <br /> ��,15-� _Electric _Gas_Other �U^'�5• Z� <br /> WORK�ESCRIPTION <br /> Rov��jl�t– � n P4wvrvblYr� Wur1� <br /> PLUMBINO MECHANICAL <br /> N0. TYPH OF FIXTURE OR ITEM N0. TYPE OF FlXTURE OR ITEM <br /> , Tollet FVC-air handling units <br /> � Betl�tub _ Forcedairsystems <br /> _ Lavatory (wash basin) Gas piping <br /> Shovrer Waler heater <br /> _ Kitchen sink 8 dlsposal _ Gas fireplaca I <br /> Dishwasher Gas range <br /> � Clolhes washer _ Clothes dryer <br /> �_ Wciter heater Range hood <br /> Sink(servicelbar/mop/etc.) Exhaust fan <br /> BackFlow preventer Heat pump <br /> Urinal Unit heater <br /> D�inkinn Fountain Boiler <br /> _ FloorOraln Refiiperation <br /> Grease lrap _ Woodstove <br /> Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LUC/U.SAlE9 7AX CODE IS 5105 <br /> I liereby certlfy that I havo read end examined this epplication and know ihe same to be lrue and correct. All p�ovislons ot laws and <br /> ordinances goveming thls typo of work will be complied with whether spedfied herein or no[ T� e grandng of a pertnitdoes not prasume <br /> to give euthority to vidate or cancei the provision of eny other state or local law regulaung constructton or the performance of <br /> w�struc0on. That I �. aulhorized by the ar✓ner of this property to pertort�the work for�vhich appliwtlon is made and I comply wRh the <br /> Slate Cont actore 18.27 RC a�d 296.200 WAC. <br /> �1"2�- � <br /> Signamre . Contractor/Authariz Apent Date <br /> c <br />