Laserfiche WebLink
11RR-23-2011 10:24 FROt9:C8t1 HEATIIJG 425-745-1344 T0:14252578857 P:2�4 <br /> ( � <br /> i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D CEDAR STREET, EVERETT,WA 9£i201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLIC:ATIONS ARE ACCEPTED FR0�7 8 AM TO 4 PM ,�j ��--� ( <br /> SITE ADDR[SS PARCEL TAX I.D.p PERMIT i! <br /> �� ne Vtl ► ia�- �3`d <br /> LE A l0T NO. LOCK TRACT OR SUQ�IVISION N <br /> � DE9C. <br /> OW ER AODHE55 CITY2IP PHDNE <br /> , �aul Pxew� �(c3� SG�� Ave S Rvt�rn � R`6� i �ZSZi3�flZ(o <br /> TF�NAME CONTACT FOR PEflM1T PIIO <br /> -� � �z'� 2S9 ��E � <br /> E�r1AIL <br /> ry�� ESS L;� ��� �y� / PMD E <br /> CONTRI1UnCE�NuSE--M,�n-�� �I�C I��S �'�.�A�L1 C�_ _[L� �'�� (J� �� I <br /> - /� �r�, f '_ 1 7/1 <br /> Ltl� t'IC1-�-✓� Q`1�f\�4' -1 CXl <br /> USE OF BUILOING I HEAT SOURCE I CON�T('RACT PRICE�NORK <br /> �' E�cciric ,_Gas Other 'Y��'j 3 <br /> WORK D[SCRIPTION <br /> 1 �15��i l 2 I�►� �Qc��l- �uM(o �- (-�-�r �-�'�- � �-f� <br /> � <br /> PLUMBING MECHANICAL <br /> N0. TYPC-O�FIXTUflE Oil ITEM NO. TVPE OF FIXiURE OR ITEM <br /> Tcllet A�C-air handiing unis <br /> — g���'��U � Forced 2ir systems <br /> _ Lavatory(wash basin) Gas piping <br /> ShOv,�Cr watcr heater <br /> � KItG�on sink&disposai Gas Ilreplace <br /> _ D�ah�vasher � Gas range <br /> Ciothes washer � Clothes dryar <br /> _ Water healer Range hood <br /> Slnk(service/barrmopiulc.) Exbaust fan <br /> ^ Backfiuw preventer �_ Heat pump <br /> � Urinal Unil heater <br /> Drinkin�Fountain Boiier <br /> Floor Jrain Fetriperaiion <br /> _ Grease irap Woodst ve <br /> Roel dmin; �� Other��,��� <br /> ____ Olher <br /> CITY OF EVEfiG I7 LOCAL 3ALES TAX COOE IS�105 <br /> I hereby cerltlly th�t I h�ve rcad and examined this application and know the sama lo be true and correq. Ail provislons ot laws and <br /> ordlnaces gavcrning this rype ol work�vill be compl�ed wilh whelher specil�ed herein or not.The granting o1 a permit does not presume <br /> to glv�authonry to vlolale cr cancel the provision of any olher state or local law reAulating wnstructlon or the parformance ol <br /> conctructlon.That I am authonzed by ll�e owner of this propedy�o perforn the work for which application is made and I comply with the <br /> State Coniractors Ww t 82 CW and 296.200 WAC. <br /> . �E ��wc 3 23�i I <br /> Sipnmure t ownencontr�clodmm�onzed�n� Oatc <br /> I <br />