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FROM :Evergreen Stdte Hedt & Ai( FRX N0. :4252596660 Jin. 10 2008 07:SBAM P1/1 <br />l <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, Wq 98201 <br />425-257•8B10 - FAX 425-257-8857 - ww�y,everettwa.org <br />APPLICATIONS I�RE ACCEpTED FROM 8 AM TO 4 PM /` / p�-U� <br />sirenooaess � ...___. __.._ _ <br />CON7RACTOR <br />�+'i�Gn�aY s� • +ys�lT ' ✓�/G <br />CONTp, LICHNBE K <br />UBE OF BUILDING <br />WORK DESCRIPTION <br />CONTACTFORPERMIT <br />PIiONE <br />ADDRE53 CITY2IP PNONE <br />.7/.�0 �iliific AK EY. '.�10 / <br />S'2S -�s� -T!/ V <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />_,Elacidc �Oae^Other �.,j $DO �` <br />/ws� c� GAs T�s.�tyiP �` G� �� �'AS �Oi�/ir.G <br />NO. I TYPE OF FI%Tl1RE OR ITEM <br />T0110t <br />__._, Defhtub <br />Lavetury (waeh bnsln) <br />Shoiver <br />_ Kltchun slnk & clisposal <br />Dlshwasher <br />_ Clotho3 wnsher <br />Laundry trny <br />_ Slnk (service/bar/mop/etc.) <br />Backtiow preventer <br />Urinal <br />Drinklnp Fauntain <br />Flaor draln <br />„ Greose tr�p <br />Raol dralns <br />,! OlhOr <br />NO. <br />TYPE OF FI%TURE OR ITEM <br />rv� — eir nanaung units <br />Forcotl alr syytems <br />Gae pipinp <br />Water heeter <br />Gea fireplace <br />Gps rBnBe <br />Clothn dryer <br />Ranpe hood <br />Ezhaustfan <br />Healpump <br />Unit hseler <br />Boller <br />Raldperation <br />Woodslove <br />Other <br />CITY OF EVENETT LOC�L gALEB TAX CODE I! �t05 <br />I hereby ceritify that I have reed end examined this appilcallon and know the eamo to be trua end correcL All provieions of lawa end <br />ordlnnces governing this type ol work wlll ba compliod with whather speclfiod hereln or not. The prantlnp pf a permtt does not presuma <br />to plve authorlty to vlolate or cancel tho provision of eny othnr etata or locel lew reguloting conehuction or the parformance ot <br />constructi at I am authorized by tha ownar ot Ihle property to perform tho work for whlch applicatlon la metle wnd I comply with the <br />Stete niractu s L�w ta27 RCW and 288.200 WAC. <br />