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From:iMAC INC. <br />To:914252578857 071�1/2011 03:57 �673 P.002/003 <br />C �- <br />PERMIT A�PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S'TREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROAA 8 AM TO 1 PM <br />SITE ADDRE88 PARCEL TAX I.D. � <br />9�./ L�sT e <br />�o wT No. e�xK rn�cr on susorv�on a <br />DESC. <br />pyyNE D 8 ITY/LP <br />�✓��rr fibca'iNG �i�'%�y - 2��5 i5'``�.c�r�f • �'►.� <br />7ENANTNAME <br />� �/�} <br />!ti/G <br />co�rn. uc� � /MA-eZ "`"`I�PIr3.BC� <br />USE OF BUII.DINO <br />PEHIIR <br />NEATSOURCE <br />✓Eleclrfc ✓oes_ane� <br />iRr <br />D%'O! <br />%z�-3o3 -i�s <br />�r/'�� rn�nc 3�0 <br />iro <br />�GP,t/v� S�zf/—!��.� <br />CONTRACT PRICE OF WOpK <br />WORK DESCRIPTION //bS�:u,IL I'f�Q.t�.7 G.�=�jltl' .Stjlc�-'OlF i RGN!/l� /V�l�..) CdP�f� <br />/�.vc-s � a.[.c, AkW-J'�s (.serc �+..`Ttac�D �uGy oF•st.�P,g �' wo.a-c ��,�uiqa� <br />Np. � TYPE OF Fp(7URE OR REM <br />BatAtub <br />Levatory (waah besln) <br />Slawer <br />iGlcMn sink 3 disposal <br />DUMnsMr <br />doUip wAsher <br />Wdx MMer <br />Slnk (servioeibedmop/etc.) <br />Backtlow preventer <br />Urinel <br />qMklnp Fournain <br />Fbor draln <br />Groass trap <br />Roof dialns <br />Other <br />NO. I TYPEOF/IXiV11EOHREtA <br />NC — tlr hrrWliq unks <br />Forced alr syslems <br />Ci�s pipkp <br />W�Ix Meter <br />c;es nrap�aos <br />6ea rarps <br />Cbthea dryer <br />Ranpe hood <br />bfiaust ten <br />Hwt pump <br />Unk heater <br />Boibr <br />ReMperatlon <br />Woodotove <br />Other <br />CITY OF EVERETT LOCAL SALEB TA1C CODE IS i106 <br />I hereby ceritMy that I heve reed a�d e�mined this applicatim aM know tM sams lo be true and conect. All povisions ollawc end <br />ordinacee povemfrp this lyps ol work wlll be complied with whather speclfled hsrein or not. The prentirp o1 a permtt does not prosums <br />lo pive authorlly to violate or cancel Me providon of eny other slete or bcal law repulafinp conftruclion or ths perlortnancs ot <br />oonatruction. That I am aulhorized by the owner of lhb property ta perlorm the wo�fc lor whlch applicatlon ia mede end I oompy with lhe <br />St�te Contractorc,6�pw �2qACW end 298200 WAC. <br />