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FROM :Ever9reen State Heat R R.� FRX NG, :a252596660 i\ Sep. 19 2008 11:22F:`1 P1 <br /> PERMIT APPLICATION <br /> CI7Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 88201 <br /> 425-257-8910—FAX a25-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEb FROM B AM TO�pM <br /> 91TE ADDpESS PApCEL TAX I,D.1 <br /> 33� �t7 PERMIT N <br /> LEGAL LOiNO. BLOCK T1IACTOIISUBDIV1610N! MO� -O <br /> DESC. <br /> I <br /> Cc�� 3 O� 7� . CL.. �v.� ��.Z • �� 'e(�� <br /> TENANT NAME I CONTACT FOq PERMIT PMpp�E <br /> E•MpL <br /> G'2L'R6��.s'h'i�fltrfi'�lc' <br /> CONTR.�L�ICEN�SE�f ��LU �/fG/F(� �ry- �Z,J� �SZ •3��!/ <br /> �'-�.1 Si6 ��e i T <br /> U9E�F BUILDING MEAT 80URCE I CONTqACT'PqICE Op WORK <br /> ������/`�Z I _Electric �Gae_Olher � �/v� � <br /> WORK DESCRIPTION —' <br /> /iv��r�� G'�s zu�ir/.s'� ,Ft�vD �iJ¢� �fi�-i�72 <br /> UM INO -�AECHANICAL <br /> NC. TYPE OF flXTUHE OR ITEM NO. TYPE OF Fl%TURE OR ITEM <br /> _ Toilet NC-elr harMting unitc <br /> __ Bethtub Z Forced elr syslem� <br /> _ Lava�ory(wash basin) Z Gac plping <br /> _ Shower ( Wn��rhoete� <br /> _ Kitehen eink&dlsposal y Ga� `ir�placc <br /> _ Diehwaehor Gas ranAe <br /> _ Clolhec washer _ Clolhes dryer <br /> Weler healar _ qange Mad <br /> ` Slnk(aervlee/bar/mop/eta) Exhaust len <br /> _ Backtlow prevsnter Heat pump <br /> _ Udnal � Unit heater <br /> _ Ddnking Fountein � Bollar <br /> Floor dreln _ RetrlBeretion <br /> ` O�eaeotrep Woodetove <br /> _ Rool dra�ne � Other <br /> _„_ Olhar <br /> � CITY OF EVEpETT LOCAI.SALEY TAX COD[IB�105 <br /> i horeby caritlty that I have raad a�id oxamined thle epplleetion and know the eeme to Ce true nnd correct. All provielons ol laws end <br /> ordineces povaming thie rype ol work wlll be complied wlth whslher epecHlsd hereln Or not.Tha grant�ng of a permlt daes not presume <br /> to 8ivo authority to vieleta or cencel lhe provlslon ol any othor slqte or looal law regulaling construCtion or th�pertormence al <br /> const�ucllop�7�pt I am authorized by Ihs owner ol Ihis properry lo pedarm 1he work Por which appllnANon li mqde and 1 comply wlth Ihe <br /> Stata ntracto�k Law 1E,27 RCW and 208.200 WAC. <br /> ll _�Slgnature of or/ ontracto�rize AOo��� ate <br />