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Cct. i4 2013 1U: §bN�� �Jo. 022) P. i <br /> PERIIAIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> . 3200 C[DAR STREE7, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425•257-8857-�nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /D ,I�-I�_ <br /> SITEA�R[ � _P�RCELTAXI.D.q p�RM�H � <br /> 2 `iJ M I :,► O - O <br /> � LEGAL lOT q0. BLOCK TRACT OR SUBDIVISION A <br /> DESG. <br /> OWNER AODRESS qTY21P PNONE <br /> ��� �; � i . � �.�a., a� 3 aa� ��� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE(,;'Z�� Z � .(�1 <br /> 12 [-�aaiC��b�71P.C'C1�111�t711L:1• i7l'�i <br /> co cYb-- R ��1 ��1yyy �''' S��1 --ty (�p -�7T��� �I1 �T�1�b7AE-/-/�! /-- � <br /> cmHea`�nqlnc� ��'�� V vw� ��r�/l -It7F�.i� 'f��..lL�C/to1c�7K/ <br /> CONTR�`�15��� 095R4 <br /> USE OF oUILDING HEAT 90URCE CONTltACT PHICE OF WORK <br /> �Elottri� _Gas�Other ,�� ��� •Q <br /> WORK DESCRIPTIQN ��s.� i� �a � ' '"f 1 "'�"'� "'yY `4� ��� �� <br /> 1 <br /> PLUM8ING MECHANICAL <br /> N0. TYPE OF FI%TI1PE OR ITEM N0. TYPF OF FIXTURE OR ITEM <br /> iodet NC—air hantllinp unds <br /> _ Bathlub Forcedairsystems <br /> - Lav�tory(wash ba;in) Gas pip�ng <br /> � Shower ' � VJater heeler <br /> Ki��hen sink 8 di5po5di Gas luepiace <br /> � Dishwashel � Gas ran�e <br /> Clolhss washar Clott�os dryor <br /> _ Waler heatur Ranqc hood <br /> � S�nk(SCrviCC/bdr/fnOp/MC) � Eyh�uSl 18n <br /> � E�ockllow prevemer � lleat pump <br /> Unn�l Unit hea�er <br /> Dnnkinp Founlein Boilcr <br /> FlOordrain � HClrigerDlion <br /> Grence trap W oodsiove <br /> ROM dralns Other <br /> O�Itnr ��y <br /> GITY OF EVERETT I OCAL SALES TN(GODC IS 7109 <br /> I hereby cernily Ihai I have read and examine0 thls eppllcallon and know Ihe same lo be Uue and correcl. All provlsions ol laws and <br /> �rdinaces yovernin�this lype ol work w�ll be complied wlth wheihor,pecllletl hereln or not.The prnntlng ol a permtl does not nresume <br /> lo givn authonry lo vblato oi r.anco�Ihn pravision of any othar slale or�vcal law rogulaling cvn,li�Gion or tho pc��onnant�ol <br /> construcilon 1 hat I am authorized by Ihe ownor ot lhis properly lo periorm Ihe work lor wb�ch apphr;�hon Is rnadr.and I wmply vnib ihe <br /> Sizte Conlradnr Lcw 1f127 RCW nnd 296200 WA,. <br /> . <br /> ��u,_1� LD �1�:L3 <br /> Sipnalr, a of OvinedCoptratlodA�lh ��, Agunl Gate <br /> (. <br />