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06/07/?OG6 13: 16 2062487905 BRENNAN HEATTNG PAGE 02/03 <br /> i 1 <br /> PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982D1 <br /> 425-257-8810—FAX 425-257-8857—�wwv.everettwa.org <br /> (�� v7- c�: <br /> APPLICATIONS ARE ACCEPTED FROM 9 AM TO 4 PM <br /> SITE ADORESS PARCEL TAX i.J.# P^�,RMIT# <br /> '7�1t�'� �AI►.11�b�2 003°i3lo00��01 �1 1�'1GCoC'�C[,-�.� (p <br /> LBGA LOT NO. BLOCK TRAC? <br /> DESC. <br /> OWNER q�DRE55 CI1YfZIP PHONE <br /> 'F�o'G�RT CA�e�Y�.G '790�{ 'RA�ti��b►Q �vcr�ETr �F�S-ss5-�o88 <br /> TCNANTNAME CONTACTFORPERMIT VHONE <br /> SHAc,��r.lErot.� A1.lE�.► �o�- a'�8 .�°10� <br /> c:ONTRACI':R A�ORESS CITY2IP PNONE <br /> '�RE�.I r.lA't.l l-IEA`r��1E�ti A1� I a��a�g�-zaoo <br /> ' CONTR.LICENSE��z1<Eur.�NAq.'7iIZq ' '��01 S l3'�I-n+�L TUK�1l��l+JA �I8�(vb' <br /> USE OF BU�LDING HEAT SOURC[ CONTRACT PRICE OF WOp,K <br /> gF� �Electric _Gas_Other I �'�I�(o�� �^J" <br /> WORK OESCRIPTION <br /> �I�l.g 1�I� 3�F.1 �EAT�UN� t� <br /> IPLUMBING MECHANICAI <br /> NO. TYPE OR FIXTURE OR ITEM ND, TYP[Of FI%TURE OR I7EM <br /> _ 7oils� A/C—ni�handlingu�it5 <br /> _ �alhtub Forcedairsystems <br /> lavato�•�wash basin) � Gas pipiny <br /> Sho�,ver � Water heater <br /> I _ Kitchen sink&disposal _ Gas fireplacc <br /> Dishwnsher Gas range <br /> Clothes washer � Clothes dryer <br /> � Laundry tray � Ranga hood <br /> Sink(servicelUar/mop/etc) hau64�{p <br /> _ DackOow preventer __J._ Heat pump <br /> Unnal , � <br /> � Ddnking Fountaln Boiler <br /> _ Floardrain Ref�geralion <br /> Grease tfap Wocdstove <br /> � Roofdrains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7A%CO�E IS 7106 <br /> iI herehy ceritify thnt I have read and exnmined ihis appllcation and know the same to he true and cortect, All provlsions o`laws and <br /> oMinaces goveming this type of work wi11 be complletl with whother specified herein or nm.The�ranting of a pertnit does not presume <br /> � to give authonty to violate or cancel thc provlclon of any other state cr local iaw reguialing constructlon or the pedormance af <br /> I CO1IS�NGIiOn ThBI I 0111 Au�I10�iZetl he owner of this property to perform the�wrk for which appiicatlon is made and I comply with the <br /> � Sinte Co .orc Law 78.27 RC an o 00 WAC. <br /> SignMurc o(o vneqGon ractor/Aut orized Agent � Da� <br /> � <br />