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f,7ay 30 12 01:15p Washington Water Heaters 4257461563 p.1 <br /> P�RMIt APPLICATION <br /> C17Y OF EVERETf PERMIT SERVICES - <br /> 3200 CEDAR STREET, EVERETT, WA 95201 <br /> 425-257-8810—FAX 425-257-8857—v,rww.everetlwa.org <br /> APPLICATIONS ARc ACCEPTED FROM B AM TO 4 PM <br /> SITE ADORESS PARCEL TAX LD.N PERMfT# <br /> '�S Z 5�' #�u'� Gc.? -z�v�[r3oo zo�i�taU -�C�,a <br /> L[G!1 LOTNO. BLf)CK THqCTORSUBDIVIS10Np <br /> DESC. <br /> OVlNER ADDRESS <br /> ' • CITY2IP PI10NE �� <br /> U 1� v�c Ca1�uUL �t;z. 5� ��re. � �' ,eU�ff �z � 3 /' `I, <br /> TENANi NAME � -r 'Z=�1 C� <br /> IpONTACTF RPERMIT� PHONE ����`���,�'T�1�— I <br /> `1CI.CCi ��.,IZr�IS �.hotwaf�i�`/ au e a1r <br /> C NT1AiACT�0L -�j� n- //� J/ `A,,I ��! ' [-MAf �. <br /> WIiS�lIn1�Jj�UN �/iTG/�-lY�r�j RESS I AJV t�V'`�lf� S I IP PH �R���_ �) <br /> CONTR.LICENSE �G fC. 1� w , <br /> r���tSFI�-r�� 9�c �P Pa�(!���cce l.v�z 9�o5 ���8 <br /> USE OF Bl11LDING HEAT SOURCE CUNTRACT PR10E OF WORK <br /> ��l������'U�-- � I �Electric �Gas_Other I I GG Q <br /> WORK DESCRIPTION <br /> C �Gi..r e. 0��� ( a�.� ��:�� �'U2 a.-� <br /> PLUMBING MECHANICAI <br /> MO• TYPE OF FlXTURE OR REM NO, TYPE pF FlXTURE Op ITEM <br /> _ Toilet !VG–a�rhandlin units � <br /> Bathtub � -- 9 <br /> _ Lavalory(wash basin) _ Fa�ced a�rsystems , <br /> Showcr Gas piping <br /> Kitchen sink&disposal .� water heater � <br /> Dishwasher _ Gas fireplace <br /> Cloihes washer ._ Gas range <br />� Waterheater _ Clothesdryer <br /> _ Sin4(service/badmop/cic.) _ Range hood <br /> Backflow preventer __ Exhaust fan <br /> I�ea[pump <br /> _ Urinal _ Unit hcater <br /> _ Drinking Fountain _ Boiler <br /> _ Floordrain RefrigaraGon <br /> _ Grease Irap Woodstove <br /> _ Ro01 drains Othcr <br /> _ Other -- <br /> I — -- <br /> � CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br />� I hereby ceriti(y that I have read and oxamined this application and know the same to be tme and correcl. All pmvisions of[aws and <br /> ordinaces governing ihis type of work will he camplied with whether specitied herein or not.The granting of a purmit does not presume <br /> to c�ive authoriry to vlolate or a�ncal tho provisfon of any ofher state or local law rogulating construMion or fhe per!ormance of <br /> constructien.Thai I am authorized by ihe owner ot ihis praperty to pedorm the knrk lorwhich appiication is mada and I comply wilh the <br /> Slate C�nfre rs Law 18.2 R W�nd .200 W/�C <br /> ��9�� � ��l�t,�� J`•j�j -JZ �"c.2��2a'��u.Z e� lt�x Ci�.�� �{-G <br /> Sig'natar Owner/ContraclodAu honzed Agent Date ����-�r !'i'�+�'Y� <br /> �1���.e u�-e C� iv�� c�n� L.� �r}r �o-nt�cc-ta��-la�l '�``►►�u,� -�vC�+rac <br /> � ; , <br /> � <br /> -t�`1GNl�l,�U��,� --- <br />- - - - - <br />