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APR-I;-2011 08:58 FROM:C8M HEATING 425-745-1344 TO:14252578857 P:4,6 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32DO 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 />SITE ADDRESS <br />41v22 4U es} Vi w <br />Da-', <br />PARCEL TAX I.D.1t <br />PERMIT F <br />e <br />v <br />LEGAILL LOTNO. <br />DESC, <br />BLOCK <br />TRACTOR SUBDIVISION <br />OWNER <br />Bch ► uti�w� <br />ADDRESS CITYIZIP PHONE <br />qL-22-ti\16+Vi'ew rky-, 6/U} U210-3 �i25 13CSD <br />TEUANT NAME <br />CONTACT FOn PERMIT PHONE <br />E-MAIL <br />Z�ATtiAL <br />C�'1 3e hnq Ivtc <br />RL;S rrzlP D -�"-- <br />14►5 rL�c�L� Eder�t1 �I.BaJ! y-252�� &r <br />couTR. a IcC11SN <br />USE OF BUILDING <br />HEAT S�URCE CONTRACT PRICE OF WORK <br />I <br />`7"530.'2-o <br />„Electric S/Gas Other <br />WORK DESCRIPTION <br />F.eoace"ga5 -fi;rnaii c* 1ns{a z -iz:n Af c_ <br />PLUMBING <br />MECHANICA <br />NO. TYPE OF rw iuHE OR ITFM <br />NO. TYPE OF FIXTURE OR ITLM <br />Toilet <br />_ <br />A/C- an handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />= <br />Shower <br />T <br />Water heater <br />Kitchen sink 8 disposal <br />P <br />Gas fireplace <br />DishwasherGas <br />range <br />Clothes washer <br />C <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink (scrvlce/bar/r, late.) <br />Exhaust tan <br />8ackilow prevemer <br />,� <br />Heal pump <br />Urinal <br />Unit heater <br />Dunking Fountain <br />Boiler <br />Floordraln <br />Refrigeration <br />Grease t <br />Roof drains <br />Otheersif�, G <br />other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31D5 <br />I hereby coritify that I have read <br />and examined this application and know the same to be true and correct. All provisions of laws and <br />ordtnaccs governing this type of <br />work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors La 18.27 RCW and 296.20D WAC. <br />btk bmls <br />4 l 3 ,I l <br />Slgprature of Owne�Oniractorm <br />;i onzed Agent Date <br />