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Jan 12 10 12:56p Washington Water Heaters 4255726781 p.5 <br /> � t <br /> pERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> . 425-257-881�– FAX 425-257-8857–wv�nv.everettv+a.org <br /> IAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �_�Z —� <br /> SITE ADDRESSC PARCEL TAX I.O.N PERMI7A <br /> ' �v ,�au�e�� �U�(�$CGv 1 �c� � �I/���i-7� <br /> I LEGA LOTNO_ BLOC! TAACTORSUBDIVISIONi <br /> ! �ESG. <br /> I OWNER —_ <br /> ADDRE55 pTVl21P PMONE <br /> �fvL�ce '�u�c���� �czo ���.�ie� ��a�-�_�?� �' 4���,-�{7� <br /> TENANT NAME `� ONTACT F R PERMI � MIONE GO-97k� �� <br /> I�(ZCG 9..1Q,111�.�,5 I ma e•Ma�{"l�Wi1-{C�'y OtC �tt�l � <br /> GUfiSNINGrTO� IURT�2Y�!'��-/�A1D 15(XJ Ckr�.r ,$ �ry.c� <br /> ��.��E�E &u.c k r� � F��B <br /> �� 9�0 oP /�e�levr� l.v�- 9�05 <br /> USE OF BIALDIyG HEAT SOURCE I COKTRACT PRICE OF WORK <br /> �����Cy�(..(�. �Electric _Gas_Other � ���CJkC <br /> IWORX DESCRIPTION <br /> '� GQ�c�,u.c c��.1- l e�,ec�.1,c.� �.�c�.�,' 1�.Ec�,.d��, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> _ Toilet NC—airhandlingunits <br /> _ Oathluh � Forcod air syslems <br /> _ Lavatory(wash basin) Gas piping <br /> _ Shower Walerheater <br /> _ Ktchen sink 8 disposal Gas fireplacc <br /> _ Dislnvasher _ Gls range <br /> Clothos washer Clolhes dryer <br /> � Watcr heater Ranpe hood <br /> _ Sink(service/bar/mop/etc.) ` EKhaust han <br /> _ Backiiow preventer Heal pump <br /> _ Urinal Unit heater <br /> _ Drinking founlain Boiler <br /> Floordrain _ Refrigeration <br /> _ Gruasc trap Woodslove <br /> _ Foo�drairts _ Other <br /> Other <br /> CI7Y OF EVERETT LOCAI.SqLES TAX^p0E IS 31 OS <br /> i hereby ceritity thzt I Ik7ve read and oxammed tlds application and know Iha same to be true and correcL All{xovisions of laws and <br /> ordinaces govemir.g this rype of x�oik will t:c cemplied wilh whother specilied hemin or not.The granlinp of a permit does not presurne <br /> lo givo aulliority lo�iolale or cancel the provision ot:uiy other stale or local law regulaling cor,struction or ihe performance al <br /> constrvction.That I am author4ed by Iho owner of Ihis pmpeny fo pedorm the worY,for whi�application is mode and I compty�vi1h the <br /> �St Cnnlrac�o�5 La�v 1827 R�and 2962C`�"AC <br /> �,L-G(',t `-U.'� %t�.-Cz-et,ct s�J �—t �-�`��' <br /> Sufnature ol OwnorlContr c�or/AuthonZed Agent Date � <br /> Y <br />