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IJpl�-q-201R 17tf_j5 FF.'OFL'CSFi HEATING 425-i45-1'44 <br />rn:ia�s�s�eHs� P:2�5 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FNC 425-257-8857 — w�rhv.overeltwe.org <br />APPLICATIONS ARE ACCGPTED FROM 8 AM TO 4 PM <br />SITEADDRE83 �1� � S,A' <br />Y�1 yV <br />IEGA LOTNO. BLOCK <br />OCSC. <br />o En <br />�nm�rns��h <br />PARCEL TAX I.D. A <br />OR SUBDIVISION p <br />CON7RAGWN in� I�NS 3ratJ "� <br />^�� Nea�iaq <br />CONTA. LIC[NSG A _ _ _ _ . . . � . �... r- �.. 1 <br />USE OF BUILDINO <br />c e�e-E{- q <br />li-s-�� <br />PERMfT R <br />/ _ i <br />7MUN[ <br />�3 �rZS B o7 q(o�73 <br />�S 25�1 CoE6 6 <br />1� 4zs 2sq ���� <br />— HEAT SOURCE I CONTRACT PRICE OF WORK <br />Eleclric V6as_Othe� ���� _ (�(� <br />WORK DE$CRIPTION <br />Ins�-ull c�v�+tess hea�i- (�� r�� <br />NO. I TVPL OF FlXTUII[ OR REM <br />Bathtub <br />Lavatory (wash basin) <br />� Snower <br />Kltchr_n c�nk 8 di;posal <br />Di;hvncher <br />� Clolhe3 wnsher <br />WOtCf hV81Bf <br />Sink (seMceroarlmop'elc.) <br />_. Bnckflow p�cvante� <br />Urinal <br />^ Drinking `ount0in <br />� Floor dm�n <br />� G�Oasc t�np <br />Roof d�alns <br />_ Other-- -- <br />NO. I TYPE pF FlXTIIRE pR ITEM <br />/uG - a�r nantliinq uni�s <br />Forced au sys�ems <br />` Gas Pipinp <br />Water heatsr <br />Gns f�replace <br />Gas ranee <br />Clmhes dryer <br />` Rnn�eh00tl <br />EKheU5113� '._-11 <br />_� HCat pumP GN.�.��lE$S <br />Unit hsater <br />oouer <br />Refrlperotion <br />^ Woodslove <br />�� O(hB� <br />CITY OF EVEItEYT LOCAL SALES TN( CODE IS 7705 <br />I hCreby cornity that I have iead nnd r.nom�ned �his appGcation nnd know Uio same to be irue and wrreet. All provislons of iaws and <br />oroinocea povemmg Ihis type ol �vork w�n ba comphed with N1,elhar specilied hereln or not. The qianting of a permlt tloes not presume <br />In pive nulhnrity 10 wolflte or cancel �he provislon of any other stato or locat law repulnling constNetion or Ihe perlormanOB o1 <br />con,truction, Th�t I am nuthonzed Gy the owner of Ihis property te perlorm the vrork tor .vinch eppiication is mnde and I compiy wilh the <br />Stato Coniroc rs I_aw i(i 77 RC nd 236200 WAC <br />��b� Q!� C I I-�1 • i O. <br />Sipnaturo ol nr.ri onlractorr pthnr�zed �Be�� � Date <br />