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12/ly/2010 NED Il1OO PA% 0001/OO2 <br /> 1 <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SEFiVICES <br /> 3200 CEDAR STREET,EVERETT,WI19B201 <br /> ��26-267•BB10-FAX 425•257-BB57-www.ovoroltwa.e►g <br /> 4PPLICATIONB ARE ACCEPTlD FROM!AM TO 4 PM / 2 -/S��d <br /> 81T8 ADDq�99 � n� � PA 3EL TI O�D.�F1 D� Pi11MIT 11 <br /> � � Mio � a - c"�"� <br /> LEOA l0T NO. �� LOCK TII�CT OR BUBDIVI910N/ <br /> OC9C. , E <br /> OWN�R <br /> ��n.��_�'nr���.y����� a�R T�er�t� °18'a��aa-�► -a� <br /> TENANT N11M! I <br /> E�1A�L <br /> glU� Fl.�'�'�'LF— LIC. 711 �p22 O'�`• S� . w r� W10JM�1Ll�(CIfN�I �Ibl7�S 4a.5-�7�-1�39 <br /> COMR.LICENBE M <br /> p,I.vEFL,Y �"1R <br /> UBE OF OUILDINO I HEAT SOURCE OONTRACT PIIICi OF WORK <br /> I —Elxlrla �Oee_Olher ��u, 0� <br /> .._.J_ <br /> WORK DESCRIPTION <br /> I�ngltal\ o?`t6�� 9j�\� Zonc: � <br /> -' P MBINO <br /> NO. 7YP!0!'FlY7UHE OR REM NO� TYPE OF Fl1(NII!01117EY — <br /> p/�..alr hendllnp unitt <br /> Teum — Forcd alr tyetams <br /> � Balht�b '— Geb plpinp <br /> _ Lavatnry(wneh besin) � yya1e�ryealor <br /> Snower . 0��IIreP�aco <br /> _ Kitchen elnk 8 dlsVOD91 '� pee ronpe <br /> Dlahwad�e� — Clotha�drysr <br /> � Glothoc wa�her Ranp�hoad <br /> � Water hnnlai J Exhwfl hn <br /> _ Slnk(MrvkdDarlmup�alc.� �� Heet{wmp � <br /> ^ BaeknowprevoNer UnNhoaUr <br /> Urinal � Oellor <br /> _ Ddnklnp Fuur,ialn ` qetdpor,�tbn <br /> Floor tlreln '— y�/ppdyi�va <br /> � Orewan trep � Olher, <br /> � Rnol drpina <br /> � Othor <br /> CI'fV OF EVERFTT LOCAL BALt!TAX CODE 1!1100 <br /> I homhy ceAUly thel I heve road and enumined thlo epplicetlon and knaw lh���ma to bs true end Cortect. All provl�lon�ol lawe�nd <br /> nrAinacee govorninp fhls typs 01 work wlll b�Complled wllh whetMt apNMled Mrsln Or nat.Ths prantlrp 01 a De�mll dws nOl pawm0 <br /> �o plve authorhy lo vlalale ur cnneal Ihe povle�on ol eny othor sllu ar Iocd lew repul9llnp oorolNCtlon or IM psdampnCe ol <br /> conetrucllc�n.Thet I authod:e by IAe own�r of�hla propeAy lo peAorm tho work lor whlch applk�Uon b muds and I comply wilh 11» <br /> 51 te omraclorr I 18.27 R d 298.200 W AC. <br /> 5'gn��l w ar nl�ac or u r zn pe�l ��� /v <br /> I <br />