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FROM :E�ergreen State Heat & R��" FAX N0. :4252596660 � Nov. 02 2010 11:10RM PS <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�1`'� PARCEL TAX I.D. M <br />V <br />LEGAI-L LOT NO. I o""'^ <br />DESC.r <br />O�IA N� . <br />�0,\� � <br />TENANT NN+IE <br />�V r 1..�-� � <br />fl�tiavl `�� � . Yh9.-1c <br />CONTR. UCEN6E Y � <br />n�e���a�7�a�aoT ' <br />USE OF BUILDING <br />?�� 4.vLCn <br />WORK CEgD RIPT70N ' l <br />C��' b ��� <br />LU G <br />NO. I ME Of fOCTURE OR ITEM <br />Tollet <br />Bathtub <br />Lavatary (wash besin) <br />Sltower <br />Kitchen slnk 8 disposal <br />DiFhwasher <br />Clothes washar <br />Waler haeter <br />Sink (servlcelbar/mop/etc.) <br />BecklloW preventar <br />� Urinel <br />^ Drinking Fountaln <br />Floor draln <br />Grease trap <br />Roo( dralns <br />Other ..— <br />TRACT <br />FOR PiRM1T <br />HEATSOURCE <br />J�Eiadrlc _ Gas _ Olher <br />(l �-D 2- —lf� <br />pERM1T M <br />[�ANL �1J�1'dt I�QSS Ml� . <br />� ��.�,;�.5� 311� <br />CONTRACT PRICE OF WORK <br />" - - - "� <br />N0. I TYPE OF FIXTURE OR REM <br />AIC — air handlinA unRs <br />Forqed alr systems <br />Gas pipinp <br />Wator h�ater <br />Oes fireplece <br />Gas renpe <br />ClWhes dryer <br />Renpehood <br />E#�ausl fan <br />Hoat pump <br />UNt heater <br />Boller <br />Rehiperation <br />Woadetove <br />Olher <br />CITY OF E�RETT LOCAL SALES 7AX CODE IS �10b <br />I hereby certiy thel I heve road and examined this appiicatfon and know the same lo be trus end correct. All providone of lews end <br />ordinances governing this rype of work wlll bu comPlied wlth wfielher spaGfi�d herein or not. The granU�g of a pemUt does not prseume <br />lo give authorily to violete or cancel the provision of any other alate or local lew repuleHnp consWcl� lonrta mada�und I comply with tha <br />conetructton. That I em nuthurized by Ihe awnor oi lhis propxrty lo W�orm tho work tor wh�ch aPP <br />State C��h�actors �a�w18.2: RCW and 296.20o WAC.\ 1.� r1 � • <br />