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SEP-22-2010 06:23 FROM:CYM HERTING 425-7a5-1344 <br />� <br />SYfE AODRESS <br />LOT NO. <br />DESC. <br />T0:14252578857 P:2�3 <br />\. <br />PERMIT APPL9CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257•8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. X <br />S-�' 003 330Q� <br />RLOCK TR,e=T OR SUe01VISION 11 <br />/4�L'RESS <br />t[f �2o r�'ladAson�' <br />I CONTACT FOF PERMI7 <br />yyn�nn��Vo <br />�n �-1�af�r►� 1nc ►y��5 <br />CONTR. 41GENSE R _ „_ � �,,�, r <br />USE OF BUILDING <br />� � O I� <br />q—�Z—�a <br />PERMIT p <br />�l 1 l�C�'1— 03 � <br />� ��W <br />PHONE <br />�.n rrur r� vnc <br />��erei� � �'zo i �-7.5 Z�► ��� � <br />HEATSOURCE <br />_ Electric �/ Gas _ Other <br />WOFiK9E5CRIPTION ��,� �S une,• �n$1RII CiQ$ <br />v�a�x' hFG�4�'' ,� <br />NO. I TYPE OF FlXiURE OR fTEM <br />Toilet <br />Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />�' Kltchen sink E� diapos3t <br />Oishwasher <br />� Clothes washor <br />Watcr heater <br />Slnk (seroice.'ba�/mopletc.) <br />� Backflow provenler <br />^ Urinal <br />! Drinking Fnuntain <br />r Floo�drain <br />Grease irap <br />Rnof drains <br />Othcr <br />CONTRACT PRICE OF WpRK <br />� q3�3•ao <br />QCR.. �Yl$'tZ1�� '�r�E.SS <br />NO. I TYPE OF FlKTURE OR ITEM <br />P✓C—air handling units <br />� Forced air systems fu mC.�+ <br />= Gas p�ping <br />�, Water heater <br />Gas fireplace <br />Gas range <br />,_ Clothes drysr <br />Range hood <br />Exh�ustfan <br />� Hea1 pump <br />Unk he2t@r <br />Boiler <br />,_ Refrigeration <br />Woodstove <br />,� Oiher <br />CI7Y OF EVERETT LOCAL 3ALE5 TAX CODE IS 3105 <br />I horeby ceHtlfy that I have read and examined thls applicatlon and know the same to be tniu and correct. AII provisions of lavrs and <br />ordlnaces govorning this type of work wnt be complled with whether specifletl herein or not. The granting of a permit does not presume <br />to glvo aulhorlry to violate vr cancel ihe provision of any other state or loeal law regulating constructton or the pertormance oi <br />corutructlon. That I am aulhodzed by Ihe ovmer ol this praperty to peAortn me work tor wh(ch appllcation is made and I comply with Ihe <br />SlBle Contractors Law 1827 RGW and 296,200 WAC. <br />17.�,[�bt�� r'>a.x��.c' 9 �ZL • lo <br />