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JUN-1-2611 07:20 FROM:C8M HERTING 425-745-1344 T0:1425c^578857 P:2�4 <br /> � <br /> PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT,WA 98201 � � I ' � ' <br /> i 425-257-8810—F! � 425-257-8857—www.averetiwa.org <br /> APPLICATION9 ARE ACCEPTED FROM e AM TO 4 PM <br /> ' SITE ADDRESS PARCEL TAX I.D.It P RMIT M <br /> C���� S-� � �/P(� `OO� <br /> LEOl1 LOT NO, BLOCK TRACT OR SUBDfVL410N I <br /> �ESC. <br /> OWNE <br /> � + �mb v ra u 18Z8 C�a�r St c�,ve,fei�q 82Q 1 a?533�{ 8 8�8 <br /> .od Terr� <br /> TfiNANT NM1E I CONTACT FOR PERM�T PHONE � <br /> E-MAIL <br /> Cl11 n� In� I��I� B•rac,�way tt'987,c�t �Szs9�o��� <br /> corttA.ucC�fi'L--ikZ�:0�15 R�-�- <br /> USE OF BUIIDINa I HEAT 90URCE I CONTAACT PRICE OF WORK <br /> �Eledrlc _Oae_Other �93�. g Z, <br /> WORK DESCAIPTION <br /> i n sla i I h�crl- �►�p �- aa r ho�,d 1 e-� <br /> PLU ECHANI <br /> NO. TYPF OF FI%Tl1RE OR REM N0. TYVE OP RDITURE OR ITEht <br /> Tollct !uC—air nandling unNn <br /> -- Bnthlu6 FO�cadair6yslema <br /> ! Levatory(wash banin) ' Gae piping <br /> � SheWer W81en c�q�Br <br /> _ Kltchen sink d disposal pas fireDlaee <br /> Dlshwaeher pas rengc <br /> � Clothcawa.hor _ G�othesdryer <br /> � Wnter heater Ranpe hood <br /> Slnh (eervice/badmop!elc.) � Exhauslfan <br /> ^ �ackflnw provr�ntsr � H�pl pump <br /> � Udnul � Unit hBaI81 <br /> _ Drinklnp Fountaln poiler <br /> Flnor drnin Rplrippra�ion <br /> � Gee�etrap ` Waotlstove <br /> Raof drains <br /> � Othcr er <br /> _ �r <br /> CITV OF EVERE7T�OCAL�ALE9 TA%COOE 18 910! <br /> I hereby ceri0fy Um! I havc rud and examined thle eppilcation end know Ihe same to ba truo a�d correct. Ali prov�ciane of laws and <br /> ordlnaces govr.m�ng this typo ot woB wlll be compllad with whather sDeeRietl herQin or noi.The prenting ot p pprmR d0es no1 pre�ume <br /> to pivo euthoriry lo violete or cancel the provision ol any other�tate ar lacal Iaw repulatinp construcflon or Ihe peAormence ol <br /> Construction. Thal I am authorized by the owner oi this proparty to pertorm Ihe work lor whlch apphoallon ia mede antl I cvmply wllh the <br /> Stato Contrndor6 Low 18.27 RCW end 29620�WAC. <br /> ��co�.. �,;� d��� rr <br /> $ignatura,p vmeN ont�act r Ut to�zed�7�STiT q o <br />