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From:IPiAC ING. <br />To:914252576857 01��9/2013 06:51 fr251 P.002/003 <br />i <br />PEI�MIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-6810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />C.�I.3% �c u.sT �� <br />LEGA LOT NO. BLOCK <br />E✓�,e�TT f/ous�NG �`'' <br />TENANTNAME <br />� ��' <br />/NG <br />CONTfl. LICENSE R /Mf}.eZ "`"'QQj- ,gC�. <br />USE OF BUILDING <br />PARCEL TAl( I.D. Y <br />7AACT OR SUBDMSION N <br />- 27i�', /5��.fjU'.e�f <br />PHONE <br />��a9-� <br />iM1T # <br />� <br />vzs-�3 -�is <br />i✓�1Ga� .n„�� �60 <br />y�P.vd� `�zSi 7°�� <br />HEAT SOURCE I CONTp:4CT PRICE OF WORK <br />✓Electric ✓Gas_Olher <br />WOflK DESCRIPTION //�j'�/ytiL�, �7•e,cJ L�^-1�-U' S�f1c,r-�vi=� i /GYU1(//�' �/t�c�I .['.pPF�� <br />/�n./�s f� a-w � kY�-J'� (sE� r9-.-rrrc�rr-� coPy aF• �evPE o�' wo iz� aPfu��7 �� <br />Np, � TVPE OF FlXTURE OR ITEM <br />� TOilet <br />Bathtub <br />�Levatory (wash basin) <br />Shower <br />� Kkchen sink & dlsposal <br />' Dishwasher <br />� Clothes waShBr <br />�,_ Water heater <br />Sink (servicalbadmop/etc.) <br />Beckflow proventar <br />Udnal <br />Drinking Fountain <br />Floor drnln <br />^ Grease trap <br />Rool dralns <br />Olher <br />NO. � TYPE OF Fl%TUpE Op REM <br />A/C - air hendiinp units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas Ilreplace <br />Gas ranpe <br />Clothes dryer <br />Ranpe hood <br />Exhaustfan <br />Heat pump <br />Unit heatar <br />Bailer <br />Hefdgeration <br />VYoodslove <br />Olhar <br />CITY OF EVEqETT IOCAL SAlES TAX CO�E IS 31D5 <br />I heroby cerilify lhal I have read and examined this application and know tha sama to be irue and correcl. All provEsions ol laws and <br />ordinaces goveminp this type of work will be complied with whether spbcmed herein or not. The prentinp oi a permit does not presume <br />to give authority to violato or cancel Ihe provision ol any othor stete or locel law repulatlnp consiructian or the perlormance of <br />construclion. That I am aulhorized by Ihe owner of th(s property to perlorm the work lor whlch applicaUon is mada and I comply wilh the <br />S�ate Contractors�w }�2�fICW end 296200 WAC. <br />/-+�%.�/3 <br />