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06/11/2010 16:37 FAX 4252578742 <br />� <br />81TE <br />�or <br />7ENANT <br />+ CE�AR f�00�1/007 <br />PERMIT APP�ICATI4N <br />C17'Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE77, WA 98201 <br />426-257-8810 — FAX 426-'t57-8857 — www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />BLOCK <br />, IC. �E � t.ruiE � <br />CONTFi. LIClNBF N OG�/VC.J�� <br />FARCEL TAX I�D� N <br />TRACT <br />I - -�.�1�i �a� �I�h <br />CONTACT FOR PERMIT <br />C�,+:e.� 17e i�1 <br />usE oF.eui�oiNG HEAT 80URCE <br />Ju� "`� ElocUlc _ Ea9 _ 0lher <br />WORKbESCRIPT10N rj ^ <br />�7G W�\�, � . <br />\� <br />NO. I YYPE OP RIX7URC OR IYeM <br />_ Toilal <br />_ Bathtub <br />Lavelory (weeh baeln) <br />� 6honnr <br />_ Kltchon a�nk d dlepo�ol <br />` Dlshwachor <br />_ Ctothea waeher <br />_ Wotar hootvr <br />_ Slnk (oorvlw/hcNmoplelc.) <br />Backflow p�evenlar <br />Urinel <br />,_ DrinklrpFountaln <br />Floor dmin <br />6roaso vap <br />� Roof droine <br />—_ Olber_ <br />.• S� �d <br />� PHONE <br />acl�- ��..�, � <br />G '-j �i �-ro <br />PERMIT t� <br />� Im u� -ol <br />CONTRACT PRICE OF WORK <br />NO. I IYPE OF FI%7URE OR ITEM <br />w�.—xirnenmmp uniu <br />Forcod alr syatoma <br />Oaa plDinp <br />Weter hoatar <br />Gas firoplaco <br />Oas range <br />Clothes dryer <br />Rangahood <br />Exheustfan <br />Heat pump <br />Unit heater <br />Boilor <br />Reirlperatton <br />Woodctova <br />vtner <br />CITY OP eVERETT LOCAL 6ALE6 7NC COOE 16 310d <br />I horoby cartlTy that I twva rend e�d ezar�lined .hla epplicalio,n and know the aeme te be we ond corract. All provlslons of lawo end <br />ordinances goveminp thls typa ot Work WIII be Complled Wllh wheUtef 9peCl�ad hel6ln or not. Tf�9 Crantln9 af a portnit doa. nol prosume <br />to glve euthodry t0 vlolele o� CanCel tho provlslan of any othet ctata or local law roeulatlng mnctructlon or the pertortnance o[ <br />cansWcpon. That I om Uiariz the ewnerotthls propertyta perForrtt tha work for whlch appllcadon le mado ond I cOmply wlth the <br />State Contraotcr Le B. 7 a tl 296,200 WAC, <br />__ _ � �� /% <br />0 <br />Z/6 d ZhL8LSZ52'! « 9995�6ZSZ7 �tu�dwo� 6u�aog ayl L£�56 6L-90-OlOZ <br />