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07-09-'08 13:07 FROM- T-71E PFt02/003 F-226 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDA? STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX•125-257-F1B57 -bwnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i SITG ADDRESS PARC@L TAX I.D,ri PERMIT p <br /> � 2632 RUCKF_R AVE 00439161501600 /� ) "� <br /> . LEGAL LOT NO. EiLOCK TRACT <br /> DESC. <br /> �j OWNER AODRESS CITYIZIP PHONE <br /> MADRONA ASSOCIATION 2632 RUCKER AV[, [verett 98201 425-308-6752 <br /> TENANi NAME I CONTACT FOR PERMIT PHONE <br /> Naida KhanlNorthwest Permit Inc 360-945-2787 <br /> CONTRACTOR 1�/ESCO ADI7RESS CITYI2IP P �—� <br /> CONTR.LICENSEY WASHIES9"1106 2800 Thorndyke Ave W Sealtle, 981 s 206-378-6649 <br /> USE OF DUILDING HEAT SOURCE CONTRACT P <br /> Commercial _e������ x Gas_Olher �5400.00 <br /> I WORK DESCRIPTION <br /> � Replacing 1 gas to gas G82-156 COMMERCIAL water heater <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTIIit[OR ITEM NO. NPE Of FI%TURE OR ITEM <br /> Toilet A/C—nir handling units <br /> Bathtub Forcod air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower ' Water healer <br /> IU;Gien sink&disposal _ Gas fireplace <br /> Dishwasher Gas range � <br /> Clolhes washer Clolhes drycr <br /> Laundry Iray _ ftange hood <br /> Sink(scrvic�142dmop�elc.) Gchaust fan <br />. '— BockOow preventer � Heat pump <br /> Urinal Unit heater <br /> Drinking Fountam _ Boller <br /> J Floordrain Refngeration <br /> Grease Vap � Waodslove <br /> Roof drains Olher <br /> Other <br /> I <br /> CITY OF @vEREiT LOCAL SALES TN(CU�G 15�105 <br /> I h¢reby canbfy lhat I have read and examined U�is applicaden and know Ihe same lo be lrue antl wrrecl. All provisions of laws and <br /> nrdinaces governinn lh!s p pe of vrork will be complied vAth vA�ethor sped6ed herein or no1.The granling ol a permit does not presume <br /> to give a�:horily to violate or c;ancel the provision of any other state or local law rn3Wating construction or the peKormance ol <br /> consL uction 7hat I am aulhurized 6y the owner of ihis property to perform Ihe wrork for kliich application iS m2de and I compiy with the <br /> Stat�Co ct L�w 1�27 F , enA 296.2p0 WAC. <br /> �-�------ O��n9�Od <br /> Signa�ma o vmcd onlrador uthonzed Ag^nt D2 <br />