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Nai 27 12 05.59a <br />SITE ADORESS I <br />'1 7 � G / 1 I"�' <br />LOT NO. <br />TENM7T NN.tE <br />Washington 1Nater Heateis <br />4257461563 <br />PERMIT APPLlCATION <br />CITY OF EVERETT PERMIT SERVICES <br />320D CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 — FAX 425-257-8a57 — www.everetlwa.org <br />APPLICAT�ONS ARE ACCEPTED FROM II AM TO 4 PM <br />BLOCK <br />�. <br />GrTO►� /U/�iC-2?'N�F� <br />1 <br />USE OF BUILOING <br />1�C' Sl G� �11�1G�. � <br />WORK DESCRIPTION <br />C <br />0��� <br />NO. � TV PE OF FlXTURE OR I7EM <br />Bathlub <br />Lavatory (wash bastn) <br />Shoaer <br />Kilchen sink & disposal <br />Dishwashcr <br />Clmhes washcr <br />W aler hra;er <br />Sink (5erviceNar/mopletc.J <br />Qackllow pieventor <br />Uiinal <br />Drinking Fountain <br />f loor drain <br />Greasetrap <br />Rool drains <br />Other <br />PARCEL TAX I.D. A <br />TqAC(OR SUBOIYISION p <br />w� <br />IMIT` <br />PHONE <br />G VGCL u%CL lI�U05 <br />I1EAT SOURCE <br />_ Electric �Gas _ Olher <br />I �>�� <br />p.1 <br />PERMIT # <br />�►�.o"��-o3in <br />10NE <br />y�� �/o� <br />� <br />CON7RACT PRICE OF WORK <br />�'f�G.`� <br />UJG�:�-��� �'U2 �.� <br />NO. I TVPE OF FIXTUfiE OR ITLM <br />A/C — air handling units <br />Forced ai-sys;ems <br />Gas piping <br />_L Walerheater � <br />Gas lireplace <br />Gas range <br />Clolhes drycr <br />_ Range hood <br />Fxhawtlan <br />lic�t pump <br />Unit I'�calcr <br />Goilcr <br />Refrigcration <br />Y✓oodslove <br />Olher <br />CITY OF EVEREff LOCAL SALES TA7C CODE IS 9105 <br />.� S., n�} <br />I hereby centily thal � havo read and examined this applicaGon and know the same lo be tnie and corrocl. All p�ovi,ions ol ia�vs and <br />oidinaces govem;ng this type o! wmk �vill he complicd with wholher specificd herein or not. The grantin� ot a permit doos not presume <br />to give authority to violate or canccl Ihe provision of any olher slato or local law reguiating .;onstruceion ar the pedormance ol <br />cons�ruction. That I am authorized uy Ihe owner ot Ihis prnperly to peAomi the N�ork brwhich appllcaGon is made and 1 comply u�iUi tn2 <br />Statc Conlmctors Law 18.27 RCW and 296200 WAC. j��, � <br />��` I to " � '"" �.y, dbN��Z G:r S'L-1c: CLN'i-,i '�� <br />�- i�r-ti-'�'J ���a� . � _ / � ; <br />Si naWre of OwnedConiraclo7Au r ed A ent Date 1��7Li'YCI:,IZ7� �.- ti.:'11 <br />9 D i I . Yn4tiq�uU I�,` <br />����l.�Q l.l� �J 1V1�11 (�i"l,Fl�.� ���' i�G"t1� �lL'l.�i'U� MC�I��j��r'f}'�.1,�" '�U CG`(�I1 <br />