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Nov 21 11 11:40a <br />Washington Waler Heaters <br />� <br />4257461563 p.1 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 88201 <br />425-257-8810— FAX 42�257-8857 —www.everettwa.org <br />ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Plb <br />SITE AGDRESS <br />r <br />LEGA LOTNO. BLC <br />DESC. <br />OWIE�rv' I <br />Srr� ys� <br />IENANT N11ME <br />N �Ar <br />�5 lNGtTdnr lt1A�E2 <br />coNrn. uco+se • _ _ _ . <br />USE OF BUILDIN(i <br />�sld� <br />WORK DESCRIPTION <br />C ��� <br />V` l <br />ou.� <br />NO. � 7YPE OF RXTURE OR ITEM <br />Toilet <br />8athtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 dfsposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink (service/barlmop/eleJ <br />Bacifiow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease hap <br />Rool dralre <br />Other <br />PARCEL TAX I.D. X <br />7IiACT OR SUBDIVISION R <br />�PERMR� <br />GU1iG�S <br />,� <br />cvuc <br />HEAT SOURCE <br />�Electrfc _Gas_Olhor <br />N0. <br />! <br />�>a 9Sr�o5 n��sa <br />I CONTRACT PRICE OF WORK <br />rr.�. , .o <br />�Ja� %� a-1-e,r� <br />T'PE OF Fl%7URE OR (1EM <br />NC—airhandlinp units <br />Foicad air systems <br />Gas piping <br />Water hea[er <br />Gas Breplace <br />Oes �e <br />Cbthen dryer <br />Ranpe hood <br />E�aust lan <br />Heat pump <br />Unit healer <br />Boiler <br />Hehtgaratfon <br />woodstmre <br />qTY OF EVEfiETT LOCAL SALFS TAX CODE IS 31 OS <br />t hereby cerid(y that I have read and oxamined this applicaGon and baw tho same to be irue and cortecL All provfabns of laws and <br />ordinaces qwemirg this type of work wiB be complfed w(th whelher specNied hereln w nol. The gran8ng of e pertnft does not presume <br />ro give authority to violaM or mnml tha proviaion of any olhar stato or loeal law bpulaUnp coretruction or th� p�rformanoo ol <br />wnsW dion. That I em authorized by the m�mer ot this perty to pertortn the work 1or which application is mads and 1 aomply with Ma <br />St/jMe'9e��}tr-a�aars Law 7�8.27/ R�C�W and 98200 WIIC. �i �� <br />l` / LLii.i� �-�i ! • . <br />' vm ivuwnu actuunum�n mc.. nycn. <br />u�-e.Or� �� �,n�il� �rm �or�t►�c� �-la�l ��e�%tx�- -{� <br />