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FP.011 :Evergreen State Heat 8 Air FRX N0. :4252596660 Ru9. 27 2010 01:22PM P1 <br /> � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-F�910— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � —�� —� <br /> SITE ADORrES�S PARCEL TAX I.D.M PERMII'� <br /> c��J(� I v 1Ql�UCIID� � �I C�'�-'-;- �. `-J� � <br /> LEGAL LOTNO. BLOCK TRAC�OR3UBDIVISIONA I <br /> DESC. <br /> OWNER ADDRE55 ITYZIP P NE <br /> V '` h �e►ln �.�.Q. ��5b� Vuu.�cn��- I�,r N�v •�1 ��83�3 <br /> TEN�NTNAME I CONTACTFORPERMIT PHONE <br /> � � E�F1AILlSAi l�N.� <br /> AD RE ITY I NE <br /> � ��A-t vr��-� a5o""� ��cnv� Rre. C� �5� -311� <br /> CONTR.LICENBE N C•r4` a�� �Q <br /> e.ve ��,sbaao� _ ���, ��- � oao�, <br /> U3E OF BUILOtNG HEAT SOURCE CONTRACT PRICE OF WORK <br /> R9 C� „� � ��(' � _Etectnc _Gas_Olher � y�� � <br /> S 15 '�' — <br /> WORK OE9CRIPTION <br /> � `��� -�-� ��P <br /> PLUMBING MECHANICAL <br /> NO, TYPG OF fi%YURE OR ITEM NO. TYPE O�FIXT:IRE OR ITEM <br /> Tollet A/C—alr handlint)units <br /> 9alhtub Forcod air systems <br /> � Lnvatory(wash basin) Gas pipinp <br /> Sliower Waler huale� <br /> � Kitchen slnk&dlsposal Cas fireplace <br /> Dlshwasher G,s renge <br /> Clathos washer Clothes drye: <br /> Watcr hentcr Ran• :hnud <br /> _ Slnk(servlca/Uar/mop/otc.) Er �ust fan <br /> �._, aack0owpravenlar � Hoatpump <br /> UAnal Unit heater <br /> Udnking Founta�n Boiler <br /> Floordrain � Refngoration <br /> Groaso�rap WoOdstove <br /> � Roof drolns Other <br /> Other <br /> CIIY OF EV[R[TT LOCAL 9ALE8 7AX COb[16 3105 <br /> I horeby r.artify Ihat I have rend end exemined ihis applicatlon and know the same ta he true and cnrreM. All provisiona of laws and <br /> ord�n,ncos govominy this type o(work��411 be complled with whelher spocified hcaro�n or not.The pranting of A permlt doas not presume <br /> lo givo au�honty in violate or cancei Ihe provision ot ony olher stnte or Iocnl law regula6ng conetrur,Hon or fhe porformance of <br /> coneaucUon. Thet I am authonzetl by tho owner of lhis proporty to padorm Ma work fnr which npnlira�ion Is medn nnA I compty wlth lhe <br /> ��lo Contrectors Law 1927 RCW and 29(i.20D WAC. <br /> .��;l��e��--1 �s� ��l/10 <br /> Signaturn ut��e`,on r.lnr Authonzetl Apent pn�� <br />