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Sep 20 2010 11:OSRM West Seattle Furnace 206 935-0735 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERIVSIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-0857 — wv �v.everottwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� <br />LOTNO. � BLOCK <br />OESC. <br />ItA{:1 VK <br />t.v�,v�.�-� �-lc�...1� 1� <br />R. uceNSE a <br />USE OF BUILDING <br />WORK DESCRIPTION , � <br />PARCEL TA% I.D. t <br />'RtACT OR 9UBDIN910N i <br />ICONTACT FOR PERFM <br />�cu��:, � W � �r.�.v�.vu�.,,� <br />�� � �3�ah p� ..,,,,.� <br />�zaakl-� �18t lo �, <br />HEAT SOt1RCE <br />I � Elactrle _ Gas _ Other <br />\ '�� C�-�-C � J� <br />NO. I T'PE OF FlXTLRE OR ITEIA <br />Bathtub <br />Lavalory (wavh baein) <br />Shower <br />FGtchen sink 8 disposal <br />Dishwesher <br />Clothes washer <br />Water hoater <br />Sink (se^.dcelbadmop/utc.) <br />Beckflm�; preventer <br />Urinel <br />Dr:nking Fountain <br />Floordreln <br />Grease trap <br />Roof dralns <br />anor <br />NO. <br />p.2 <br />PERMR �I <br />j;���,�_ ��, <br />PMONE <br />ya5 � a39 . g� oq <br />PHONE O flf <br />ao� a���� <br />CONTRACT PRICE OF WORK <br />g� C�L'�� <br />� v r� <br />TYPE OF FIXTURE OR ITEM <br />rv� —alr nenCling unils <br />Forced air systems <br />Gas piping <br />Watcr hoeter <br />Gas fireplace <br />Gas 2nge <br />Clothes dryer <br />Rango hood <br />E#�aust fen <br />Heat pump <br />Unit heater <br />Boller <br />Retrigoralion <br />Woodstove <br />Olhor <br />CITY OF EVERETT LOCAL SAlES LU( CODE 19 J105 <br />I horeby ecrtly that I h�vo renC end examined Ihis appllcaGon and know the same to be true and �pRect Afl provi6lpns of lewa and <br />ordinences goveming this type af work will he complied with whelhor specifiodt�erein or not. Tha grant np of a pertnit doea not presuma <br />to give authonty to vlolate or canoel the provision of any othar atoM or Iccal law regulating conxVuctbn or�he performance a1 <br />1 � c wctian. That I em euthonzed by tho owner ot thls property lo pertorm the ,nyrlc �ur wh;ch application is mnde and I compfy yrith (!�e <br />tat ConVactors Law 78.27 RC1(V a�d 296.200 WAC. <br />�.1 /���Y\ .t � t—h-, -�. - � l � 01 t � <br />