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Jun 11 10 12:OOp Washington Water Healers 4255726781 p.2 <br /> ( <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> - 425-257-8810-FAX 425-257-8857-wwny,everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 pM S �I(�I� <br /> SITI[ADD+RESSj �/1 �A/ 1/ PARCEI.TAX I,p,�J <br /> 1 ��1 l�b�'vl��(t " U aaJoS��oo�_�p PERMIT# rJ <br /> LEGA LOTNO. BLOCK TAACTOR5UBDIVISIONA I �`�I IOC[p �' O/Q <br /> DESC. <br /> OWN[R <br /> ���! „ r �� ADDAESS CITY2IP PHONE <br /> ��_ �_ �-�� �oz( �o-u�.t�td �-v-c.. �,�qszor .3vr-��y <br /> TENANTNAME ON7'ACTF RPERMR� � <br /> PHONE Q��C���� cy <br /> �acci �cu���.fs (�,�,(,�� /�� ° <br /> cociJ{tSt�INGtTON GUf{-TE2l�/'��/�AD�RES / ZC+'(/ /�,nJ� � C1 IPE-MAILl1PU/W�TG�ycue clffi <br /> �l.<VZ (/� ���_ � <br /> �oNT(�)CENSE��rC� 9Sf0 �P &uc d/e � flV <br /> USE OF BUILDING ��!e�� �Q ��v� ��� <br /> � p � HEATSOURCE CON�CT ICEpFyyORK <br /> V^l_ ?� Eleclric _Ga�_Other �� <br /> � WORK DESCRIP710N <br /> �L�'t'`-�G�,�- ��?rt� ( C�J ,�Lt�G%�� �'L���-f/ <br /> PLUMBING - - <br /> NO. 7YPE OF FlXTURE OR ITEM M ECHANICAl. <br /> NO. TYpE OF FIXTURE Oq ITEN <br /> _ Toilel <br /> _ Bathtu6 ,_ NC–air handfing unils <br /> _ Lavatory(wash hasin) _ Forced air systems <br /> _ Shower Gas pipin� <br /> _ Kilchen sink&disposal .L Water heater <br /> i � Dishwasher _ Gas fireplace <br /> _ CloUies wasbcr _ Gas range <br /> _ Water hea�er _. Clothes drye� <br /> _ Sink(sorvicol6ar/mop/etc.) _ Ranga hopd <br /> _ Back(Iawpreventer _ Exhausttan <br /> _ Urinal _ Heat pump <br /> _ Dnnking Fountain _ Unit heater <br /> Floor drain _ Boiler <br /> _ Grease trap __, Relryeration <br /> _ Root drains __ Woodstove <br /> _ Other _ Other <br /> — --r__ <br /> CIN OF EVERETf LOCAL SALES ThX CODE IS 3705 <br /> I hereby ceriGly Iliat I have read and oxamined this applicaGon and know the same to bo wo and conect. All provisions of laws and <br /> ordinaces governing ihis typo ot�tirork will be compGed wHh whatfier speci(ied herein or noL The grantinfl of a permil does not presume <br /> to givp authonty lo violate or cancel tFe provision oF any other stato or local la�v regulatin�consWclion or the pedormance of <br /> ruction.That 1 am authorized by the rnLTer of Riis property to peAorm�he u�ork for which applicafion is made and 1 comply with Ihe <br /> State ontr�ctors La y .p7 qCyy d�y����WAC <br /> Si Wre o(Owner/Contrect d uthoriZed Agent � '( �/�O � <br /> Date - <br /> � <br />