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FROM :Evergreen State Heat S A,,( FAX NO. :4252596660 "g. 26 2004 02:13PM Pl <br />t <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 68201 <br />425-257-8810 — FAX 425-257-8857 — www.evorettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. a <br />PERMIT II <br />/7.28 U,�w <br />UEGAQ <br />LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />ADDRESSC I PHONE <br />n n ,( <br />�(l/'C . ;�'V \ <br />_ <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />I <br />Z <br />CONTRACTOR ADDRESS CITYMP PHONE <br />9vy i <br />7 lJ <br />CONTR. LICENSE <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />'Z7S <br />I <br />�Iactnc _Gen._Other <br />1 <br />I <br />WORK DESCRIPTION <br />�1t-Lrx.� � Q�c ci • O� F.�u5'�-72 S Fad <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />N0, TYPE OF FIXTURE OR ITEM <br />Total <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />_ <br />Water heater <br />_ <br />Kitchen sink A disposal <br />_ <br />Gas fireplace <br />DIGhwa_ <br />swasher <br />Gas range <br />Clothes <br />_ <br />Clothes dryer <br />_ <br />—_ <br />Laundry tray <br />Sink (servleeroar/rrlop/otc.) <br />_ <br />Range hood <br />Exhaust fan <br />Bacdow preventar <br />_ <br />Heat pump <br />Urinal <br />_ <br />Unilhester <br />Drinking Fountain <br />^ <br />Boller <br />Floor drain <br />_ <br />Refrigeration <br />Grease trap <br />_ <br />WoodNove <br />Roof drains <br />Other <br />Other <br />----- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br />I hereby codify that I have rend And examined fill application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specfied herein or not The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating eonstn ctlon a the perform inru of <br />construction. That I am suthortred by the owner of this property, to psrform the work for which application is made and I comply with the <br />Stat nt ctors Law 18.27 RCW and 296 200 WAC. <br />gnature o wno�ract— riv gent unto <br />