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JLIL-23-2010 �6:22 FROM:C8M HEATIIJG 425-745-1344 <br />� <br />T0:14c52578857 P:2�3 <br />PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVI�,:ES <br />3200 C[DAR STREET, EVGRETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — t'nvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SRE ADDR[SS <br />� m���• <br />LEG�L LOT NO. ULOCK <br />DeSC. <br />oIVNER <br />O�r `il�� �tit tr��r� <br />TENANTNAME <br />� G� ��1Cct�� n q f�� L � <br />C01JTR. LICENSE k <br />C',i11 N��-� O�S�� <br />USE OF BUILDING I <br />PARCEL TAX I.D, ff <br />oc�5q5zvooc��ov <br />TRACT OR.:UbbIVISIDN 0 <br />ADDRE55 Cf <br />o� 111c l�c��all i�tli <br />CONTACT FOR PERM <br />1��bie I ct.u�er5 <br />�S r3r�u,� EV� <br />HEATSOURCE <br />_C-lectric �Gas_Other <br />`7- a 3�-to <br />PERMIT,"! <br />ln� IOc� -C� 5 <br />PHONE <br />�BZo r �Iz� 359 �: <br />10NE <br />�S ZS�i �6�� <br />MAIL <br />sw'' y�2SZ5R ��� <br />COPIiRACT F'RIC[ OF IVORK <br />�i'��7• � I <br />WORK DESCRIP710N S,�J j�1 I7 <br />1hS�u.vL_ -�u rv�G,cr ��4ZG', AC� GJc� r � <br />N0. I TYPE OF FIXTURE OR ITEh7 <br />Toilet <br />� Balhlub <br />^ Ldvaiory (wash basin) <br />� Shower <br />� KltGiun sink 8 tlisposal <br />� Dlshaasher <br />Clothcs washer <br />Water heale� <br />Slnk (serviceibaVmopietc.) <br />� P.�Ckflpw pr@vrnL,r <br />Urinal <br />Drinking �ounlain <br />FIUor drain <br />^ Grease Ir2p <br />Rool drains <br />� Oiher <br />_I <br />t�0. � tVPE OF FIXTURE OR ITF.M <br />A�C - alr handllnp unlis <br />Forced ait systems GKtS 'fU r�iG.-C4� <br />Gas pipitig (l <br />Watcr healer <br />Gas firepiace <br />Gas ranqe <br />C�olhes dq�er <br />Range hood <br />Exhausf lan <br />Heat pump <br />Unit heater <br />8oiier <br />Refriperation <br />Woodsto�e <br />Other <br />CITY OF @VEF76TT LOCAL SALGS TAX CODE IS �105 <br />I hcrcby ceritify Ihat i have read and examined this apptication and Know ihe same ro be bue and correct. All provisions uf laws and <br />ordlnace� yoveming Ihis type of �tirork will be complied with �timether specllietl hereln or no1. The granting of a permY dces not presume <br />to glve outhoi!ty to viotate or cancel ihe pmvision of any olher state or Iocal law regutaling tonstructinn or the pertormance of <br />con,tmction. That I am aulhorized by ihe o�vner of Ihi, property ro perlerm fhe work for whi�h application i? made and 1 comply itiith the <br />Stafi C9 Pt�adurs �aw 18.2 HC4V and 29G.2001NAC�.j <br />�/.1� �7���� �/,(1'/i.r /' �'' � <br />