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FROM :Evergreen State Heat 8 R/C ( FAX N0. :4252596660 � . 16 2009 11�19RM P2 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257•81310—FAX 425•257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTE�RROM 8 AM 70 4 PM � --) ��.O� <br /> SITEADDRESS PARCELTAXI.D.y ERMI M <br /> s� s.414.¢o.v «Gsr D�?- �2 <br /> LEGA LOT NO. BLOCK TRACT OR 9U8DNI410N t <br /> DESC. <br /> OWNCR DORES RV21P PI; NE <br /> J�9�,E sc<lc:-�er.� /1 cc sz y sf/�9,Qon� �2EsT Ev. ��o / ��,t3- �s� -J3/ <br /> TfiN�NT N�ME I CONTACT FOR PERMIT PNONE <br /> E#IAIL <br /> E?^-�2 G/1G5�i S7. Sifi�T /A�7�7� .Z/Zo f�i9u.% y1,� EY_ �?O/ <br /> CONTR.LICCNB!M <br /> �`(k72G �o ,'1.d.OT <br /> V6E OF BU�DINO I HEAT 90URCE I CONTRACT PRI�OF WORK <br /> �� �d%�`/Z �\Eloctric _Gas___Othor � $� �S =G <br /> WORK OESCRIPTION <br /> G/�+!"�VCE D r•t i �'�tz j Q/� �GcRir/�9CE' � �l��T /�/�/Y!P <br /> PL MB N MECNANICAL <br /> NO. TYPE OP FI%TllRE OR ITEM NO. TYPE OF FIXTURE Op ITEM <br /> Tallot AfC—dlr hendlln�uNta <br /> - �� � Onthwb Forcad elr syetems <br /> I avutory(wach besin) Gqs pipinp <br /> Shower Woier heator <br /> Klloho�elnk 8 dleposel Gas Ilroplacn <br /> �l9hwesher _, Gns�Bnge <br /> Clothes wnohor � Clalhes dryor <br /> _. Wntor hontur Ranpa hood <br /> . Slnk(scrvico/bar/mop/olc.) Exhaust lan <br /> �� Oackflow provontor Z Neat pump <br /> Urinel _ Unit han�or <br /> Drinkinp Fountnln __ Bolior <br /> Floor dreln Refiiparation <br /> Oreaso Irep ,.,, Woodstove <br /> Reol drolna Other_ <br /> Other __..___. -..-- <br /> � CRV OF EVERETT 40CAL 9ALE9 TAX COD[1!110! <br /> I horoby corilily Ihat I havo road ond oxominetl thls appilcelion and know tho same to he true end cortact. All provlslons of iews and � <br /> ordlnacos govoming this typo of work will be complied wllh whelhor speclliod horeln or no4 Tho prantinp ol a permft does nol prosuma <br /> lo glvo aulhodty to violate or cancol tha provision of any olher ctato or local low rogulatinp conctruclion or the pertormanco ol <br /> conslruclion.Thnt I nm euthorizod by tho ownnr ol thls properly to pedorm tha work lor whlch eppllcetlon ic mada and 1 comp7V with the <br /> Stato Contfnct c Luw 18.27 flC end 299200 WAC. <br /> Q �C <br /> S pnuturo ot wner/ .onirac od ulhodzo Apcmt ate <br />