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Mov 2� 2010 9: 59RM West Seattle Furnace 2n6 935-0735 p. l <br /> I <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� -�/�� <br /> 8 TE ADDRE95 PARCEL TAX I.D.tF PERMIT/ <br /> � C�b O O � I OI/ ' O53 <br /> LEGA LOTNO. BLOLK TRACTORSUB�IVISIONi <br /> DESC. <br /> OWNER ADORE93 CITYZP PHONE <br /> �� Et< <�� �, � � �1a5 a �a � s <br /> TENANTNAME I CONTACTFORPER1fMT PNONE'ab�e a��I g �{ 00 <br /> � � Y E�►dAl <br /> ` 1 CI p <br /> �Ct�Lv�A..r� �..lew���� �q . , <br /> COIiTR. LIGENSE Y <br /> br{_w.,�a�� �_a y� o� � ��aash P� �o n.� q a� � ao� a� a a-a c <br /> USE OF BUILDING HEAT SOURCE CONTRAC7 PRICE OF WORK <br /> �C, �..„ �� �n .� •`1 J _Electric �Gas_Othor I �q � <br /> � ..• � <br /> �ORK DESCRIPTION <br /> ,p�u q a� �., r r�o,c-e � l:�1� Sror L� \l� <br /> PLUMBING MECHANICAL <br /> MO• TYPE OF FIXTURE OR ITEM NO. TYPE OF FU(TURE OR ITE41 <br /> _ Tollel A/C—alr handling units <br /> _ Balhtub = Forcedairsystems <br /> _ levatory(wash basin) _ ��p;p�A <br /> _ Shower _ Water heale� <br /> _ Kilchen sink&disposal _ Gas freplsce <br /> _ Oishwashur _ Gos range <br /> _ Clothos wasber _ Clothes dryer <br /> _ Water heater _ Range hood <br /> Sink(serv�ca/bar/mop/etc.) _ Exheust fan <br /> _ Backllowpreventar _ Heatpump <br /> _ Udnal _ Unit hoater <br /> _ Drinking Founteln Doiler <br /> _ Fioordrain _ Rehlgcretion <br /> _ Greaso Vep _ Wootlstove <br /> _ Roo(drains _ Other <br /> _ Other <br /> CITY OF EVERETT LOCAL$ALES TAX COUE IS J106 <br /> I here0y ceNfy lhat I have read and o�mminad thLs upplication and know ths sama to be trve and correct. Ail prnvisioos of laws entl <br /> ordinanws govom�ng tltia type o!work Niil be comphed�vith whelher specified herein or not.Tha granting o!e permit dces not prowme <br /> to pive authority to vlolato or cancel the provision o/any othar state or loral law regulating cons',rudion crthe paAormance ot <br /> cunsWqion. Thal I am authorizod by the ownor of lhis property to poAortn the work lor wh¢h epplicatlon is made end I comply with the <br /> S Contmdors Low 1B 27 CW and 280.2D0 WAC. <br /> ' " �.-,� � ,l� a�.l � o <br /> ig ture of OwneqContracMr/Au onzad Agent �jp <br />