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o�iu;izoii �s:•��t r•:�s a�,s2assas nous m:a��isc �oo•� <br /> � --- -- — <br /> i PERMIT APPLICATION <br /> � CIT" OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STRFEI , EVERE'I T, WA 9�201 <br /> � 425-257-8810- FAX 425-257-8857 -www.everettwa.org <br /> I APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TA%I.�,p PERMIT p <br /> ' `,511 lst Ave SE p0'79;300003300 � ��� <br /> L6(i/11 LOT NO. HLOCft TRAf.T OR SU6DIVISION p <br /> u�sc <br /> I OWNER AUDRESS CITV2IP PHONE <br /> IPort and 1�3e.len r�r, ti57.] LsC Ave St•'. GvereCl 98?.03 ��'!S- '?.12-9694 <br /> �II 7ENANTNAME I CpNTACTFORP[RMIT PHONE Zp6-378-6630 <br /> Chrictiana I�lajole E-MAIL , n.�i`���..",�;"��•-.,c �"' " <br /> � CONTRA T�—� Oii-- -S� I Iz H E <br /> �� 13eb' s Heat.i.ng and A/C 13C,33 NG 12GLh Pl.� Kirkland 800-8•10-3346 <br /> '. CONTR.LICENSE# ���5}�'j�����,n SU].tE: 350 <br /> USE OF 6UILDING HEAT SOURCE CONTRACT PRIC�OF WORH <br /> I _ Electnr. h Gas_Cthcr 1000 . 00 <br /> �------ — <br /> WORKDESCRIPTION In�Cal l watr_�n c�:7ter (1�e�,�laCemeant) <br /> PLUMBING MECHANICAL <br /> I NO. TVPE UF FI%7URE OR IiEM NO. TYPE OF FIXTURE OR IiEM <br /> I __ Toiie� AIC–air handliny units <br /> i = Ualhtub _ Porced air systems <br /> Lavatory(wash besin� Gas piping <br /> Shower _j� Water heater <br /> � _ Ki�chen sink 8 disposal _ Gas fireplam <br /> _.__, Dishwasher Gasiange <br /> i = Clo�hes washer = Clothes dryer <br /> Water heater Range hond <br /> Sink(service�badmop.'elc` Exhaust tan <br /> I Har.kllow pieventer Heat pump <br /> �� Unnal Unil heater <br /> I _ CJrinkiny f'ounlain _ Doiler <br /> Floor dr2�n Refngera(iun <br /> '. Grease lrap Woodstovz <br /> � Roof drains O(her <br /> � G�her <br /> � CITV OF EVERET7"LOCAL SALES TA%CODE IS J105 <br /> iI hereby certdy Ihat I have re��d and examined this applica6on and know�Im st�me to be tnie antl correct. All provisions of laws and <br /> ordinances ooveming this tyFe of woih wdl ba comV��eU with whether specdied herein or not. The granting of a pertnit tloes not presume <br /> � to grve aut�ority to vioiate or:ancel the provision of any oiher state or local law requlatinq construction or ihe performance of <br /> ', consirur.Uon Tliat I am authenzed�y ihe owner ol Ihis piope�ry to perfoim ihe work lor which appiicalion is made 2nd I comply v.�ith ihe <br /> ' Sta�e Conlrectors L�w 1 :?��RCW and 296 200 WI�C <br /> :� •� �' � .., <br /> / ' . L <br /> -';�� - ; ,�� %i � . 7/8�_^.011 <br /> �. '.,.f. --'- <br /> . Signaiurp nf Owner/Co rac'tnrf/�uihonzed ngent C1alu <br /> �----- - -._..__----�--------------- �---- � <br />