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425-2S2-1Efi6 CV. HEATING <br />07.24:06 a m. 03-03-2014 214 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425.257•BBI O — FAX 425.257-8857 — wwvv.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM j —� y <br />SITE ADDRESS <br />PARCELTAX I.D. # <br />PEfl rT # <br />1712 Raj nfe✓ Aje Ge✓ett <br />620 1 <br />M o3- <br />LEGLOTNO. BLOCK <br />TRACT OR SUBDIVISION# <br />UESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />Tom Set K sa.m4, as abo e, Li25 Z93 LA4Z$-7—. - <br />TENANT NAME CONTACT`, FOR PERMIT PHONE 425 -2tf-1 ' <br />ie E4MA11C1C131)ieCc,cni itil�l�_ <br />IF <br />C79C 'nq ln(- 14IS Br I ZLLI �ea�ett g87on L17.SZS�I�r<26� <br />c"Fleffi' MAMA, <br />� <br />USE OFF BUILDING <br />MEAT SOURCE <br />CONT9 CT PRICE OF WORK <br />]/ �Elec!r,c Gas Other <br />WORK DESCRIPTION <br />n5-w 1 du C k.s s he6ft pump s�+s�wvt <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Tollet <br />_ <br />A/C- air handling units <br />_ <br />Forced air systems <br />_Bathtub <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Water healer <br />_Shower <br />Kitchen Glnk 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clolhe3 dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mop/ole.) <br />Exhaust fan <br />_ <br />Backflow prevonler <br />)__ <br />float pump <br />Urinal <br />Unit healer <br />Drinking Fountain <br />_ <br />Bailer <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodslovo <br />_ <br />Real drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3103 <br />I hereby colillly that I have read and examined this application and know the same 10 be true and correct. All provislons of laws and <br />ordinates governing this type of work will be compiled wllh whether specified herein or not. The granting of a permit does not presume <br />Io give authority to violate or cancel Ilia provlslon of any other state or local law regulating construction or the performance of <br />construction. Thal I am authorized by the owner of this properly to poderm the work for which application Is made and I comply with the <br />State Contractors Law 18.27 ROW and 296.200 WAC. <br />c 3. 3.1.4 <br />Signalu of Owner/Coo1{ector/Auer z Agent Date <br />