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11/03/2008 15:11 4255589644 �MS HEATING AND AIR PAGE d2/�2 <br /> � t <br /> I <br /> — -- I <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org i <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM , <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> C��or �n,d o.e.�� s � ��r�i90000�ya000 D$ - Oo3 <br /> LEGAL LOTNO. BLOCK TRACT <br /> o�sc. 3y poUO-6 ' i2�OG`ewand %C`i2/LiI'�`L oiJ .vU. / <br /> OWNER AOORESS CITYlZIP PNON[ <br /> mFNiK FqTnJ£Hua'i c�.ael � Na ,ci.�iy� S<` �vsi•: rT� i,��Fj F,fJo � � <br /> TENANTNAME I CONTACTFORPERMIT PHGNE <br /> 5'qn:.9�A l--u«*2 `/aS K�SS' y/t,Z� c�T. l5 <br /> CONTRACTOR ADDRESS CITYIZIP PHONE <br /> 4NIUr/1-SyL n+fu�q,v�e.q� SE2V1e� � n <br /> CONTR.LICENSEp 55�� C�1�I-cawl 2��� 2' .nnMt�vn� �/,�$' bfrS J��'U <br /> ri'FJ�,� <br /> u,��v- rnsr3� 7r= - — ' <br /> IJSE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORV: I <br /> R`r.s�t».n� ; rR�-- Eleclric �Gas Other �/ �4� 3. � o� . <br /> WORK DESCRIPTION I <br /> i1� :, :9 .c. i.29n.� z cS� -�- U.qiti �[tL� Ckrwi✓�=to-W G'HS /_'-u�rn�A [L �� <br /> v PIUMBING MECHANICAL — I <br /> NO. 7YPE OF FI%TURE OR IT[M NO. TYPE OF FIXTURE OR ITEI11 <br /> ToiIM A/C—air handling units <br /> oathtub �_ Forced air systems <br /> Lavalory(wosh basin) Gas plping <br /> _ Shower water heater <br /> Kitchen siNa 8 disposal Gas 9replace <br /> � ._ Dishwasher _ Gas renge <br /> Clothes washer Clothes dryer <br /> � _ Laundry tray . _ Range hood <br /> ____ Sink(scrvicelbar/mopfotc.) Exhaust fan I <br /> _ Rackflow preventor Heat pump , <br /> Unnal ^ Unit healer � <br /> Drinking Fountain Boller � <br /> � Floor drain Refrigeration i <br /> .= Grease trep —� Woodstove i <br /> Roof droins Other <br /> Other <br /> -- II <br /> CITY Of EVCRETf LOCAL 9ALES TAX CODE IS J705 <br /> I hereby centlfy fhet I have rnad end examined this application and know the same to be lrue ond correcL All pwvislons of laws and <br /> ordinoces goverNng this type of work wiil be complied with whether specifietl herein or not The granting of a pertnit does not presume <br /> lo give authniity lo viola;e ar cancel tlie provision o(any other stale or local law regutating constniction or Ihe performence of <br /> conslruction.Thot I am authorized by lhe o�vner of ihis property to perfortn the work lor which appllcaUon is maAe entl I comply with the <br /> State Contredors Law 1827 RCW and 296.200 WAC. �, <br /> j��3� � <br /> Sgnature ol O�•mer/Contrac�odAulhonzetl Agent Date <br /> �. _ _ __.__ _ _. .__ _._- ' <br />