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Jan ?3 12 12:41p Washington Water Heaters 4257461563 P�1 � <br /> PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 320D CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810– FAX 425-257-8857–www.everettwa.org <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �..-�3�J�j <br /> SITE,AODRESS PARCELTAXI.D.N I PERMRif <br /> 33i �� �L S� . � v� - ' o - "�3 <br /> LEGA L07 NO. BLOCK TflACT Ofl 5 DIVISION A <br /> DESC. �f <br /> OWtiER ADDRESS qTY21P PHONE �S o�S� � � <br /> �� i; l r'4 ;s r^��� itr,� S3/ ySF� l�Ls� �l���� �i'� .� <br /> M� OHTACT F R PERMR� PHONE qo y� ���� <br /> 'N�� I�pCCI ��t��S E.�a�.hofw�tf�'y au� ah <br /> W fl5M 1lUGtTO� 6Ufi-i E2xf'£��A O D 1�c dC�� S � � P n o e �5�g on <br /> CONTR.FJCENSE 0 n,p`/e U� �� 9�� <br /> l.URSf�T�� `7� P ,�_, <br /> USE OF BUILDING � HEAT SOURCE CONTRACT PRICE OF WORK <br /> Cn <br /> r�s�d�n�'(G� _E��t�,� �Gas_Other � r� �f � • <br /> � <br /> WORK DESCRIPTION <br /> �G� Ou�� � Ca �-5 u�a� �'U2 a-� <br /> � �-. <br /> PLUMBING MECHANICAL <br /> p�p. TYPE OF Fl%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEN <br /> Toi:et . A!C–arhandlingunits <br /> Bathmb _ Forced afr systems <br /> Lavatory(wash basin) Gas piping <br /> Shov,er __`__ water hea!er � <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clolhes dryer <br /> Water heater _ Aange hood <br /> Sink(service/barlmopfetc.) _ Exhaus[fan <br /> Backtlow preventer Heat pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain _ Boifer <br /> Floor drain _ Refrigeralion <br /> Grease Irap _ Woodstove <br /> Roof drains _ Other <br /> Other — <br /> ' CITY OF EVEAETT LOCAL SALESTAX CODE IS 3105 <br /> I hereby cerility thal I have read and examined lhis application and know the same to be we and conect. All provisions ot laws and <br /> ortllnaces governing tius type ol work will be complied wi[h whether specified herein or noL The granting ot a permit does not presume <br /> to give authoriry fo violate or cancel the provislon of any other stafe or Iocal law regulating construction or the perfortnance o( <br /> constructlon.That 1 am authorized by the owner ol lhis properry to perform the work tor which appiication is made and.I comply wilh the <br /> Slafe�-Fonlractors Law 7827 RCW and 296200 WAC. <br /> t/�:.,,,�.,._ G�'/i� �".�o�,P �—�3'�c� <br /> '""�' Oate <br /> Signature of OwnedConlraGtrf/Authonz ent <br /> �ptl:�-Q u�-e— C '� lVl�'D � �i l� C�c��C��Cc l� P�� "�C: COT� ' <br /> �cvv��-i��_ <br />