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Sep 03 11 0937a Washington Water Heatsrs 4257461563 p.t <br />PERMIT APPLICATION <br />CiTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVER[TT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />rtCJ�C'yN(/���11 YE I <br />LOTNO. BLOCK <br />��t�,rCCS � l��,t ��+' <br />TENANT NAME <br />CONTA, <br />,7an! l�c1ArE2 <br />u <br />USE OF BUILDING <br />r�stder�-I"(Gl- � <br />WORK DESCRIPTION <br />PARCEL TAX I.D.1t <br />TRACT OR Sl1BDIVISION A <br />PEHMIT <br />'i�% / /O <br />C �+��N %8zc� <br />�L/J cHONE g�a-y7�' <br />�. h�,,,n-lo�.4 <br />,... <br />I� u� /,va 9�ia5 <br />HEAT SOURCE <br />� Electric _ Gas _ Other <br />- oolo <br />L'+9 <br />CONTRACT PRtCE OF WOqK <br />C1 Ill�-�� V�'1..� � � l'����� V.�(J�.-, l��Y ' 1SC �L�L�' <br />NO. I 7YPE OF flXT1iRE OR 17EM <br />Toilel <br />�athlub <br />Lavalory (wash basin) <br />Slmwer <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washcr <br />= Watcr hoator <br />._ Sink (serviceR�admopletC.) <br />.. Backllow preventer <br />Urinal <br />Drinking Fountain <br />— r-�cor draln <br />Grease irap <br />Rool drains <br />Other <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />�+ro — air nanam� units <br />Forced air systems <br />Gas piping <br />�4'aier healcr <br />Gas lireplaae <br />Gas ranc�e <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heat pump <br />Unit hcalar <br />Bniler <br />Relrigeration <br />Woodstovo <br />CfTY OF EVEREff LOCAL SALES TAX CODE IS 3105 <br />I licreby ceritily Iliat 1 have read and examined this application and know the same to be true and correct. All provisions ot laws and <br />ordinaces governing ihis rype of wodc will be complied with whother speciGed horein or not. The granting of a pertnit does no� presume <br />Io give aulhorily to vio�alo or cancol tho provision of any oll�ar sfale or local law rogulaling consiruction or thc pertortnnnce of <br />constmction. That I am authorized by �he qwnor 1 this pmperty to pedorm [he work lor which appiication is made and I compty wRh lho <br />ate ntraclors Law f U.27 R and 296.200 AC. <br />- 8 ) l.�i� � - � 3"�/ <br />us-e � <br />=�-Ir �1 P��'fv�c.� -iC; <br />� <br />