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Feb 07 11 1208p Washington Water Heaters 4255726781 p� <br /> �:;a <br /> � � <br /> P�RMIT APPLIC/�TION ' `:'� <br /> CiTY OF EVER�Tf PERMIT SERVICES ''` <br /> 3200 CEDAR STREET, EVERETI', WA 98201 �; <br /> 425-257-8810-FAX 425-257-8857-vnvw.everettwa.org �� <br /> � <br /> APPLiCATIONS ARE ACCEPTED FROM S AM TO 4 PM � <br /> a-a �—I� ,. <br /> SITE ADDRESS PARCEL TAl(I.D.# PERMIT� � <br /> (n t U `-t��`-- Si- SE �65 . f G `� �st; ( �v /d -f�.L?�t t�: <br /> LEGA LOTNO. SLOCK TAACTORSUBDIVISfONR �' <br /> DESC. / ���, <br /> OIYNER ADDRESS CITY2IP PHONE �- �e� <br /> Lesl.e.�, �-la�� (o�u ���="' Si- S� �:����r� �'zo� z�-r-�rc.�� , <br /> TENANT E FONTACT RPERElR� PHONE (��-y7�� � i� <br /> '� I�JI�.�(�( LLJQ,f I�L�S E-MAIU 1�G(ICL7U"� OZL� (�Jt1�� �, <br /> �flSFfI/UC�Tdl�1 lUl�TE2W'�t��"°° 1�U CfiCv- ,$ ' na �� �Yirr� ;; <br /> CONTA.LICENSE �C � � <br /> rA��+st-�tf� 9�0 �P P�II�vu.e l��- 9�'va� � <br /> '� USEOFBUILDING HEATSOURCE CONTFiACi'PRICEOFWORK <br /> �S��titij-�� _Electric ,�,Gas_Olher I � � �� � <br /> I WORK DESCRIPTION <br /> '� � �(�lCt,�c �j�'L,)- ( C��-� � �t.;�G�� ��C1�� " � <br /> PLUMBING M'•ECHANICAL <br /> NO. TYPEOFFlXTUREORITEM NO. TYPC�OFFlKfUREORITE7A . �� <br /> Toilel A!C-afrhandlfngunits �� ; <br /> Bathmb Forced air systems � ' -� <br /> _ I�vatory(wash basin) Gas piping I �• <br /> Shower _r Waterhealer � '' <br /> Kitchon sink&disposal _ Gas freplace !'_ <br /> Dishwashor _ Gas renge �:i <br /> Clotheswasher _ Clothesdryer <br /> Water healer Rang�hood ` <br /> Sink(servico/badmopletc.) _ Exhaust fan , i' <br /> Backllow preventer _ Hoat pump p� <br /> Urinal Unit heater <br /> Drinking Fountctin _ Botlar ' <br /> Floordrain _ Fle6fperation � <br /> Grease I2P _ Wootlslove I <br /> Roof drains Olher � <br /> Olher <br /> i — — <br /> I <br /> � dTY OF EVERETf LOCAL SFLES TAX CODE IS 310.5 <br /> I <br /> ' I hereby cerilify that I havo reazJ and ox�,mined lhi,apptir.ation and know the same to be ime and correcL Afl provisfons of laws and <br /> ordinaczs goveming this typz of work wil�be camplied with whother specificd homin or nol.The graMinfl of a permi[does not presume <br /> to give authoriry to violate or cancel the provision oi any other state or Ic�ca�law reaulaling constnrction or the peAormance of <br /> cops�truc5on.That 1 am authar¢ed by tho p �ner of this p��-��)rry to perform the wurk for which application is made and 1 comply with the <br /> 'StataiCo trarlors l.a 1�.�7 F�C an 200 WAC.. 3� J <br /> i � l rf � � �;� i � �n,�_� . `� 7�/� . <br /> �c.c.�.�.� t <br /> �nature ot O+vr q nlmclo Aulhonzed Agent Date <br /> ----- . . . . .. _.A. . <br /> ��. �� y.'a'�'� . <br /> ' •----- - - --- �.:..�.__ <br />