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FRIN1 :Ever9reen State Heat 8 R/(� FFlX N0. :425259G6G0 ("- Na�. 18 2010 09:SSfY1 P1 <br /> \ \ <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.everethva.org <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM r� �-I g `� � <br /> 91TE ADDRESS � PARCEL TAX I.U.�I PERI111T N <br /> o /hlO�/- D y�._ <br /> LEG L07 NO. eLOGK �xx�cr oR aueomeioN r <br /> DESC. � <br /> � 1 1 O I � t� <br /> 7ENANT NAMi I CONTI.CT FOR VERMR FHONE <br /> E�IAIL <br /> ��,. �.-w ��� ya�sa5:��iy <br /> GONTII.UCENBEA ��� M� �,.t�lC . `� f�� �F'T I�d�+I <br /> OI 1 \.(la � <br /> U9�ILDINO HEAT SOURCE CONTRACT PRICE OF WORK <br /> ' ^�� �A �. I �Electric +„Gas_Olher a�,�l V � <br /> )i� <br /> WOItK DE3CRIPTION <br /> �� ��� � � <br /> � PLU <br /> NO. TVPE OF FlXTURE OR REM NO. TYP!OF FU(TURE OR ITEM <br /> To�lot _ AIC—elrhendlhqunita <br /> Bethtub � Forc�d atr syatorns <br /> _ lavatory(waah baein) _ Ciea plpinp <br /> ShoWer _ WeterMater <br /> Kitchen sink 8 dlaposal _ Oes flreplaoe <br /> Dishweaher Gas ranye <br /> Clothes washer Clothm dryer <br /> Wale�heeter _ RenOe hood <br /> Sink(serviee/baNmoplotoJ E�ausl fan I <br /> Beckllow preventer � H�al pump ' <br /> Urinal UMt heater � <br /> Drinking Fountain . _ Bolle� <br /> Floor drain Rehigerotbn <br /> Greesetrep ,.._ Woodstove <br /> Roof droins Other <br /> — aner .__,._.__.__.._.— <br /> ciTv of evaRirr�oc�u s��s r�x cooe ia»06 <br /> I hereby certlfy that 1 have read and examined thls appllcaUon and kraw tM sem�W be trve and corroct. All providons ot laws antl <br /> ordinances goveminp this typs of work will be canpliad with whether apedlled heroln Ot not.The prenNnp of e permk doea not presume <br /> to give authorNy to violata or�ncel the provielan ot any other stete or local lew reyutetlny constructfon a the perfom�ance of <br /> consWction.ThM I em outhorized by lhe owner otthk proparty to perfam the.work for which applicetion b made entl 1 compty with the <br /> St Contraclore Law 78.27 RCW and 296.20o WAC. <br /> s�-���'� � �f�`.�. <br /> yn e o e� ontre a ulhoHz gent MC <br />