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11109/2009 08:50 BEL-RED NEATING&AIR COND. (FAX)4254935354 P.001f001 <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.everettwa.org <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE A�DRESS �f �pARCEL TAX I.D.# O PERMIT�/ D/� <br /> ��3a a�; <br /> LEGAL LOT NO. �LOCK TflACT OR SUBDIVISION p <br /> D[SC. <br /> � OWNER ADDRE55 CITY2IP PHONE <br /> �'�m �j�nerU qq �'�;��,�„�,.��r F��Y�t 9�20i (�25�z5� 9a�a <br /> TENANTNAME CONTACTF PERMIT PHONE �}�5�493 -53�"�3 <br /> S�.m� I TJ�.`R Ct t-� C�'t�li� � �'IG E•MAIL <br /> �aRYI�TSI�"��^RC�. 'k-`��,`t� �R� AUDRE�V-Z:TT�I PH F. <br /> 1��334'I+hp� � mvYalje�;v.�R98z"75 ��'t2.�44o-535j <br /> CONTR.UCENSEp <br /> �L-�REa-1 R 101 1�k <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � � ,� �-��\ _Elec�ric �Gas_Other I � R �oO •OO <br /> tJ <br /> WORK DESCRIPTION <br /> ��\azcemet�'c o-� � c�e,�S �ory��c.e, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> _ Toilet A/C-air hendl(np unils <br /> _ Balhlub � Forced air syslems <br /> _ Lavalory(wash basin) _ Gas pipiny <br /> __ Showor Waler healer <br /> Ki�chen sink 8 disposai Gas lireplace <br /> _ Disiiwashcr Gas range <br /> _ Clothes washer Clothes dryer <br /> _ Water healer Range hood <br /> _ Sink(service/badmop/etc.) Exhaust fan <br /> _ Backflow proveMer Heal pump <br /> Urinal Unit heater <br /> _ Drinkinp Fountain Boiler <br /> _ Floor drain Relrigeralion <br /> _ Greace trap Woodstove <br /> _ Hoof drains Other <br /> Olher — <br /> CITV OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> t hereby ceri�ily ihat I have read and examined this applicalion and know the same to be Irue and corract. AII provisions ol laws and <br /> ordinaces governing lhis typo of work will bo complied with�vhelher specified herein or not.The granling of a permit does noi presume <br /> to give 2uihority to violate or cancel lhe provision of any olher sta�e or local law reputaling con;(ruclion or the performance of <br /> construclion.Thal I am authorized by Ihe owner ol ihis property to perlonn the work for which applica�ion is made and I comply with the <br /> Stalo CoNraclors Law 1C.27 RCW and 296.200 WAC. <br /> Signaturo ol OwnedC- onlreclodAu�tl a�zed Agent " I 'o�9//� <br />