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Apr 06 12 02:03p Washinglon Waler Heaters 4257461563 P•� <br />( � <br />SITE ADDRESS <br />. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98207 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPtICATiONS ARE ACCEPTED FR01118 AM TO 4 PIII <br />BLOCK <br />k/ATC/L- <br />USE OF BUILDING <br />r� s�den-{'(G�. ( <br />WORK DESCRIPTION <br />C <br />PARCEL TAX I.D. �R <br />y� 7��!>f� 4 GG� S D�/ <br />R SUBDIVISION # <br />i CIIYZP <br />�,f / l�n 13/� �!/.PiY�.�f <br />f F fl PEqYR� PHON <br />Ll.1G��J E-NAII <br />� �&ul�et}� S <br />/�ellevuG Gl1Q 9fr�o5 <br />PERMITie <br />11Z04-ol Z. <br />10NE <br />��� 7��J7,J�'I <br />'d-97 -�— <br />fwaf�v`f ou � a�u <br />iLI,G ;Cr� � <br />HEAT SOUHCE I CONTRACT PRICE OF WORK <br />_�a�� �Gas_Other �h-� �e <br />Ou.� � � �� �� i�a:�°� i1�2 a.-� <br />NO. I TYPE OF Fl7fTI1RE OR ITEM <br />Toile� <br />Bathtub <br />Lavatory �wesh basin) <br />Shower <br />Kitchon sink & disposal <br />Dishwashar <br />Clothes weshor <br />Water heater <br />Sink (senrice/6aNmop/etc.) <br />8acktlow pfevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Fioo1 drains <br />Olher <br />NO. � TYPE OF FIX7URE OA ITEM <br />A/C - air handBng units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Ctoihes dryer <br />Range hood <br />Ex�aust fan <br />Heat pump <br />Unil heater <br />Boiler <br />Ref�igeraGon <br />Woodstove <br />Other <br />dTY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />I hereby cerftify that 1 have read and examinod this application and know the same to be true and correct. Ail prorisions of laws and <br />ordinaces goveming this type of work will be complied with wfiether specified herrin ar not. The granting of a pertn(t does not presume <br />to give authority to violate or canCal [he pravislon ol any other state or Iocai law regu(ating consWction or the paAortnanoe o( <br />construction. That I am authorized by the owner ol this property to porform the work for which application is made and I comply with tha <br />Stato Con[ractors Law 7827 RCW and 296200 WAC. �y�� _� <br />�(?Lj � " / /' / C7�'f�i• � L/— � — � oZ Cnur[,.2-'E4V1� GY S•C�k: C(�3t,� j '� <br />SignamreotOomudComraclor/ nze Agent Date `•�'��ZY _y 5��1 <br />�QG'.9� (.(S-e. � 1� ��(1 �i �,4 �cs' C� (rfl�"►�Ct.C�'[!� �Ctl��fi �4'u,� `i�C� G9"(�liY <br />