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09/02/2010 xxU 9: 01 PA% ��� �ity of sverstt psrmit• 000:/002 <br /> . . � <br /> ���°�°""" `�` PERMIT APPLICATION <br /> ��`�`� ��0.'� CITY OF EVERETT PERMIT SERVICES <br /> ��� �'�'� 3200 CEDAR STREET,EVERETT, JVA 98201 <br /> y'Z;,-�l"l \ =�\�'� a25-257-8910-FAX 425-257•8857-vwvw.averettwe.orp <br /> ��'r �ri�'-v1ti APPLICATIONS ME ACCBPTED FqOM .F,AM TO 1 PM 9 -a-ID <br /> 91TE�DDRESS � PMCEL TAX I.D.1► I pEq1AIT/ <br /> ���a� C; a PL w � I 1 M �ax, - ccx.o <br /> LEQl1 LOTNO. BLOCK T T11w:TOXBU�DIV1810N� <br /> DE6C. I <br /> OWII ADDIi6V P <br /> Q.b-aw�-r �:S4a Co�� ��.�1 <-i r^s� �l�i-1/�� � q��i,� �12� 11.Z3"lo� <br /> T£NANTN�MC I CONTACTFOR�ERMIT PMUME <br /> E�M�II. <br /> Q,G�E Fi.Arn F +-Lc. Z�11n22 oT+ S!. w "1 mo�mbYclt��a�a 'lEv4: 4i5-"+��-'1�39 <br /> co►rra.�k�sc• <br /> 8wE c L+aq�R.1 <br /> iIS�E O�9�LDI�� �_ I .�/ Electrk T BGeep�Othor I CONTAACT PpICE OF WORK <br /> �A' j � �Z� •� <br /> WORK DEBCRIp'TiON - <br /> � (�S�crO-SZ.. ��o..� ��Yv�(� -1– l�-Qs��.4.Cs.... y,a..ta• c�X"V�c.C'� <br /> a V �/ � <br /> PLUMBING MECMANICAI. <br /> N0, TIPE Of flXTUPE Oq fT�M ' N0. 7YPE OF R7RURE OII R!M <br /> Tullst A!C–alr hnndlirq unlla <br /> Onthw� = Forcod alr qstoms <br /> ' Lnvotory(weeh hesln) � _. Qaa P�Dlrq <br /> Bhm�,or Water heater <br /> KttcMn sl�k 8 dlapoanl � Grc flrepteca <br /> � DlBhwnshar _ a�n�9� <br /> � Ciolhes wanher ,_ Clollwo drysr <br /> Wal�r fwalor � Harqe hoo0 <br /> � Slnk(aervlCoR,nNmop/etc.) EzhauSt fen <br /> Dockllowp�eventer _L Ha�tpump ' <br /> � Urinel � Urlt�elit�r <br /> _ Ddnk�nZ fnunlaln . BoiWr <br /> Floar draln R�fr{p@fatlon <br /> Gteese trep �, _ WoodstovB <br /> _ A00f dralns � _____ �� <br /> � Other_ <br /> Cf iY OF EVl11[TT IOCAL iALB6 TA7I CODE�6�106 <br /> I hr roby cndlify that I heve reed and examined Ihla appllutbn entl know I�e�ans to bo hue end cortect. All provlsbnt of lawa and <br /> Ordinacea poveming Ihle lypo ol work wlll ba COmpllad wiih�rhotM;npsclflad henln or no6 The grentlnp of a permll doee not presume <br /> �o p�ve authomy Iu vlala�e or cancel the pvvlelon ot eny othx state or local lew ropulming ooncuuGbn or lhe pertormence ol <br /> conatructicn.T1iRt�om aulhorlxed by Iho owner ot thle propeRy to pedorm the work tor whlch eppllcntloa fe mds and I compty wkh ih� <br /> Steto Co�drodors law 1027 RCW and 29G.20p WAC. � <br /> ��a..�.� C� .� l I ���_ <br /> Stgnewro al Owner CoNractoNAut+�arized pent �—�at� <br /> � <br />