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JA14-21-2010 14:16 FROM:C&M H9EATING 425-745-1344 <br />i <br />TO:14252578857 P:2/3 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857—vrvnv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />an t Haunts �� rd PARCEL TAX 1.0. #- PERMIT # <br />LEGA L01'No. BLOCK TRACT OR SUBDIVISION <br />DESC. <br />CIWNER A DRESS CRY P PRONE <br />Dky I f) bA -L- <; R g ZO ► LIZ5 2.307 <br />TENANT NAME r <br />CONTACT FOR PERMIT PHONE j � ''^S 1 '5{ <br />;� <br />1 WtI�h ln flin91nrC _���G�fCJi <br />Vn <br />CONTR. LICEN 11L1 �11 G 1415 <br />6Je,r;V{ 9gzo 1 . 2b z59 <br />USE OP BUILDING I HEAYSCCURCE I CONTRACT PRICE OF WORK <br />—Electric ✓Gas Other 353--, G <br />WORK DESCRIPTION <br />InSig:(1 a Rh-eEm it�3'010 Z 5'i�q� cs f raaa <br />No. I TYPE OF FIXTURE On rfEM <br />Toilat <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (scrvice/badmop/ctc.) <br />Backfow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Real drains <br />Other_ <br />NO. I TYPE OF FIXTURE OR REM <br />m.N WpW- <br />� Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boier <br />Rcti igeration <br />Woodstove <br />Other. <br />CRY OF M-RL17 LOCAL SALES TAX CODE 13 3105 <br />I hereby cedtify that I have read and examined this application and know the same to be true and Correct. All provisions of laws ano <br />ordlnacos governing this type Of work will be compiled with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violota or cancel the provision of any other state or local law regulating construction or the performance Of <br />Construction. That I am authorized by the owner of this property to perform the work for whleh application is made and 1 comply with the <br />State Contractors <br />� aw 18� RCW and <br />� 296.200 WAC. j �'7 /'� <br />__ Rbb' 01—ujoC / .AQr1V <br />I <br />