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09-Z1-'11 16:99 FROM-nw permit 13609952091 T-539 P002/003 F-997 <br /> � i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV[RETT,WA 98201 <br /> 425-257-8810-FAX 426-257-8867-www.everettwe.org <br /> APPLICATIONS ARE ACCEVTED FROM 8 AM TO 4 PM C� ..� �-I I <br /> SITE ADDRE38 PA►eCEL TAX I.D.� PERMIT A� <br /> 7026 Carson Rd 00393300007300 4 - Oz� <br /> LEOA LOTNO. BLOCK TRACT <br /> pE9G <br /> WNER ITV I <br /> Judilh Hoiby 702G Carson Rd E�e�au 9s2os 425-353-9028 <br /> TENANT NAME CONTACT FOR PEHMiT PNONE <br /> Naida Khan 425-350-6047 <br /> CONTRAGTOR HOf110 D@p01 At HOA10 SBfVIC95 p�ORE88 CIIVIZIP PHON! <br /> 140 County lina Rd, 1f101 PACIFIC 800-381-5699 <br /> coNrR.uceNee� HOMED'"972R0 <br /> USB OF BUILDINO MEAT 80URCE CONTRACT pRiC�O�WORK <br /> S FR I _Eleciric _Ge�_Otha� $5500.00 <br /> WORK DESCRIPTION <br /> REPLACE 11.7 SQUARES OF COMPOSITF ROOFING. REMOVE 11.7 SQ. <br /> ADDITIONAI LAYER. NO PLYWOOD REPLACEMENT. <br /> PLUMBINQ MECHANICAL <br /> N0. TYPH OF FIXTURE OR ITEM NO. TYPE OF F�XTUR�OR ITlM <br /> Tollel A/C—eir hendlinp unils <br /> Balhtub ForcGd oir�yatemn <br /> Lnvetory(waah 6eain) Ons pipinp <br /> Shower Welir heater <br /> Kllchen olnk 8 aiaposel Oes fireplate <br /> Diahwasher Oa�range <br /> Clolhes weeher Clolhes tlryer <br /> Leundry tray Renpe hood <br /> ^ Sink(earvlcelbadmoplelc.) � Exhaustfan <br /> �ackllow preventer Heet pump <br /> � Utlnal Unil healer <br /> DAnkinp Founlain Boiler <br /> Floor dra{n RpMqpiallon <br /> 6roase trap Woodstove <br /> Roof draine Other <br /> Olher <br /> CITY OF BVERETT IOCLL b�LEb TA%COO[I6 7fOS <br /> i herotiy cerilily Ihet I have read and axamined Ihie eppllceGon and knaw tho eomo tu b�true end conecl. All provlslons of lawe and <br /> aMinacee goveminp Ihls rype of work wlll be compned with whelher specKed herein ar noL Tha g�anling of e parmit does not preaume <br /> to gWe eulhority to wolale or cancel the pravieion of any other stata or ip�el lew repuletinp conalructlon or Ihe DeAortnance of <br /> conslruciwn. Thal 1 am euthorized Uy the owner of Ihla pioperty lo pedorm ihe work for whicb applicauon Is mede end I tomply wllh the <br /> Stete Conirectors law 18.27 RCW end 298.200 WAC. <br /> ����-` 0'-�/ZI� l I <br /> $igneture�Owner oNr�ctorl o nt a v <br />