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FROM :Evergreen State Heat 8 A;� FRX N0. :425259666e Nov. 09 2010 09:01AM P1 <br /> t <br /> PERMIT APPLICATION <br /> CITY OF EVERE's(T PERMIT SERVICES <br /> 3200 CEDAR STREET. EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> ApPLICA710N3 ARE ACCEPTED FROM 8 AM TO 4 PM I�"7 `�D <br /> I E ADDRESS „ � PARCEL TAX I.D.# PERMIT# , <br /> ��Iy �� � m � � � -�z3 �. <br /> LEG LOT NO. BLOCK TRAC70R SUBDIVISION C <br /> �ESC. <br /> OWNER ADDRE IP PHONE <br /> �., �1�,,�. 1 �'���y ��4� 5� �;���t q�ao� <br /> � TENANT NAME CONTAC7 FOR VEHMIT PHONE a5�a�� au y <br /> ���A. I �„�"�Q� E�I/UL ��PSSIY1ll�. <br /> AEDRES�— -•—__.,.,,`,� �—. <br /> C'��c�s.�.h. `�.:� `blvzs.a 1'Y�1«9 `�,►20{ktci�,c l�ve �2��;k. <br /> CONTR.LICEN9Ep ��� , ua; a5a3i�� � <br /> UBE OF eUILDING I NEAT SOURCE I CONTRACT PRICE OF WORK <br /> �2C .-1 n�L� — <br /> Eledrlc�Gas_Other aG� `� � <br /> WORK DESCRIPTION <br /> �-`�,`-�.�e C�'L'`� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUCTURE OR REM N0. TYPE OF FIX7URE OR REM <br /> Toilet AIC—air handling units <br /> Bathtub = Forced air systems <br /> Lavatory(wash Uasln) _ Gas plping <br /> � Shcwer _ Waler healer <br /> � Kitchen sink d disposal _ Gas tireplece <br /> � Oishwasher ,� Gasrange <br /> Clathes washer _ Clothes dryar <br /> Water heater _ Range hood <br /> Sink(servicelbar/mop/etc.) _ Exhauslfan <br /> BackAow p•eventer _ Heatpump <br /> Urinal Unit heater <br /> Drinkina Fountain « Bailer <br /> Floor dr+3in _ Refrlyerellon <br /> Grease irap _ Woodstove <br /> Roof drains Olher _ <br /> Other <br /> CITY OF EVERETT LOCAL SALES SAX CObE IB 3105 <br /> I hereby cenity that i have read and examinod this application and know tho same to be true and conecl. All provisions oi laws and <br /> ordinences goveming this type of work wlll b��complied with whether speclfled hereln or not. The granting of a permh does not presume <br /> to give authorily to violate or cancel the provision of any olher stete or local law regulaling consiruGion o�the perfortnance of <br /> conatruction. Thal I em euthorized by the owner of lhis property to perform the woric tor which applMatinn is m�de and I comply wlth the <br /> �le Contradors Law 18.�RCW and 29fi.200 WAC. <br /> � � 1 J�� ,,,.`C�._�� <br /> Signature o wner oniractor ut onze nt �— <br />