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Jan 11 12 0227p Washington Waler Heaters <br />SITE <br />CONTR. <br />4257461563 P� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />A25-257-8810 — FAX 425-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM <br />L07N0. � BLOCK <br />lt�A�E2 <br />L <br />USE OF BUILDING <br />1'� Sl � ���"((i�- j <br />WORK DESCRIPTION <br />�- <br />NO. I TYPE OF Fl%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Cloffies washer <br />Water healer <br />Sink {servicelbar/mop/etc.) <br />�acMlow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease frap <br />Roof drains <br />Other <br />PARCELTAX t.D. R <br />ON SUBOW�SION if <br />FQ R PERNIT� <br />V_/W! !�I t%`J <br />e uc 1.va 9�a5 <br />HEATSOURCE <br />_ Electric �Gas _ Olhcr <br />� (a a.s <br />NO. I <br />L. <br />. .: <br />CON7RACT P ICE OF WORK <br />c� l o� � <br />u�G���� �'�2 a.-l�.� <br />TYPE OF FlXTUiiE OR ITEM <br />ti'G — air hantlling units <br />Foroed air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas rang� <br />Clothes dryer <br />Ran�e hood <br />Exhaus[fan <br />Neal pump <br />Uni[ heater <br />Boiler <br />ReMgeretion <br />Woodslove <br />CITY OF EVERETf LOCAL SALES TA% CQDE IS 3105 <br />I hereby ceritily that I have read and examined lhis appGcation and know the same to be We and correct. All provisions of laws and <br />ordinaces goveming this rype of work wil� be complied vrith whether specllied herein or noL The granting of a po�mit does not pmsume <br />to onty to violale or cancel the provision of a other sinte ar local faw regutating conshuction or the peAortnance ot <br />onstrucGon. That I am authorized by ihqqqQQp wner of 7 s�pioperty to pedorm the work lor �vhich appfication is matle and.l comply with the <br />State CoNm tors Law 1827 R W an�"'�00 W� <br />/_ �.� �D�,t�l/l li�v/i l_/r_i1 ' <br />—���1 p��nu,� -I� <br />� <br />