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Mar 09 12 01:35p Washingtoi Water Healers <br />� <br />SITE ADORESS ' <br />LOT N0. <br />OESC. <br />4257461563 <br />P�RMI1' APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — vnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TENANTNAME <br />�/ <br />GUf�SN'lN�GtTdN :'.1ffi�TE2 <br />CONTR. LICENSE p <br />f.1)f�c�j .'a� l�li �) <br />USE OF BUILDING <br />r�std�ni'(Gt� ( <br />WORK DESCRIPTION <br />�� <br />PARCEL TAX I.D. # <br />Taacr on sueorvisioN a <br />Fv� <br />PERMR� <br />PHONE <br />�(%lt 9�� <br />G� <br />3 -q-�Z <br />PERMIT S <br />r��3 - c� � 3 <br />10NE <br />y�s33o 8a� <br />�d�9�P'$— <br />ru�a.�evyyou � i/i <br />HEAT SOURCE COyTRACT PRICE OF WORK <br />�, Eleclric L'�Gas _ Olher � 9 7�, �� <br />��� � G���� U�GL:�� �U2a-�2,� <br />NO. � 7YPE OF FlXTJRE OR ITEM <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposat <br />Dish�vasher <br />Clothes washer <br />Water heater <br />Sink (servicelbadmop/cic.) <br />Back(low proventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grcase irap <br />Aoof drains <br />Othcr <br />C.�71 <br />TYPC OF FIl(TURE OH ITEM <br />NC - air hantlling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit hea[er <br />Boller <br />Refrigeration <br />Woodstove <br />CfTY OF EVEFiETT IOCAL S/LLES TAX CODE IS 3165 <br />� <br />I hereby ceritify that 1 have read and examined th;s applicauon and know the same to be Irue and correct. All provisions ol laws and <br />ordinaces floveming this type of work v+ill be complied with whether specified heroin or not. Tho granting of a permit does not presume <br />to give authority to violate or rancel the provision of any other state or local law regulating construcUon or the peAortnance of <br />constmclion. Tha[ 1 am authorized by Ihe owner of this property to pedorm ihe work for whicA appliqtion is made and I wmply wi�h the <br />Stat CoMracrors Caw 1827 RCW and 296.200 WAC. c� <br />�CL�Li�e'•�--�%Y7 ��c.r-EJ�3 �- % �� �1�:;?�-'i.'4'v1C;.c.�L GY S�i�Jc C(.{Ii,�j'i(,� <br />SignalureutO.wner/GontractorlAuthor• o pent Oate `��'��'r�� ���'� <br />iy 4.1 ��c <br />��Q(�:9.Q U�-Q- C"� 1�U (�(1 �[ � C�c'sT�t�C'i.Cl'U� �-iCtl�'"��i rVU.� �iC� G�i�' <br />