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Dec 30 2010 9:39RM We�*. Seattle Furnaee 206 935-0735 <br />SITE AD�RESS <br />0 " r-� <br />l[G� LOTNO. <br />�ESC. <br />OWNER <br />TENAN7NAME <br />9C �(.i'�,V�SL-a'� �-�CD-1 <br />COMR LICEN EO <br />`nr.� ,v�.t��a.-q�-t <br />USE OF BUILDING <br />J� � <br />WORK DESCRIPT70N <br />Ke�IGLC� C� q � <br />PERMlT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VJP. 98201 <br />425-257-881� — FAX 42�257-8857 — www.everettvra.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I,�. y <br />BLOCK � TftACTOR3IIBDIVISIONO <br />ICONTACT FOR PERMIT <br />_ Y�t l YY\ l-i _ <br />ADDR SS� ` �,h <br />� y b o� g�� � QL <br />g �e ��aai c. w �--- �`a ► e� <br />I HEATSOVRCE <br />_ Electric �"Gas __ Other <br />� { � � � , � � �1�. <br />NO. I TYPE OF FIXTl1RE OR ITEM <br />Toilet <br />Balhtub <br />LovaWry (wosh besin) <br />Sho�++er <br />Kitchen sink 8 disposal <br />Di^,hwasher <br />Cbthes washer <br />Waler healer <br />Sink (service/oar/mopfefc.) <br />BuckOav proventar <br />Urinal <br />Drinking founCain <br />Flow drain <br />Greaso trap <br />Roof drains <br />Other <br />NO. <br />p.2 <br />/ 2 -� � -/f7 <br />PERMIT ii <br />;M�cra -0�� <br />PHONE --�n <br />n�Ob :� �i �G Y� O� <br />ol oto �? � C� '�-q �b � <br />CONTRACT PRICE OF WORK <br />� ��� <br />�r l.: � 1�-�. <br />MECHANICqL <br />7YPE OF FU(TURE OR REM <br />A/C - air handling uni[s <br />Forced air systems <br />Gas piFing <br />Water heater <br />Gas flre�lace <br />Gas rnge <br />Clethos dryor <br />Rangohood <br />Exhaust(an <br />Heal pump <br />Unit heater <br />Dol ler <br />Refrigoration <br />Woadstova <br />Otfwr <br />CITY OF EVERETT �pCAL SALES 7AX CDOE 13 J105 <br />I hoieby certify thal 1 havg read and exomined thle applicalion ond know the sumu [o lw Vue end wrract. All provlsions of law5 and <br />ordinances goveming lhis type of Nrork wiil be complled with whether speeifod heroin or not. The granting of a pemtil does no' presumo <br />to givo authority :o violata or cancel the provision of any other slate or local law regulating consiruction or the parlormance of <br />c uctfon. That I em authonzetl b tho owner of this pmperty fo porivrm the work for which apptica5on Is mado and 1 comply Wi;h lhe <br />�tate ontroctors Law 1P.2Z RC,N �d �gp.200 WAC. � <br />