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i95/pl/2008 09:47 4252523150 HALO PAGE �2/�2 <br /> � <br /> ; PERMIT APPLICATION <br /> i CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> I 425-257-8810—FAX a25-257-8657—v,�ww.everetlwa.org <br /> I � <br /> APPLICATIONS ARE ACCEPTEd FROM U AM TO 4 PM i <br /> i SIiE AUDRG9S I <br /> PARCEL TAY,I.O.M PERMR p <br /> i ai ��cY a�e - = o �i �F3aoi �t �0 5 �-cY�1 � <br /> I LEGAL LOT NO. oI�OCK TRACT Oq SUBDIVISION# � <br /> I DBSG I <br /> OWNER AqURESS <br /> GTYIZIp FHONE I <br /> � 1�C;m �,aale�t I Prec�ur a ia�u Ru�►�rLr v �ye,rP+1 �,��i �o�o (v 5c� 1$q I <br /> I IENANi NAMC I CONTACT FOF PERMIT pHONF <br /> I <br /> InIH i L` �p ER1All. <br /> I `'�A,OC.��YLI(�j 1 U1'1 Y/ZIP •H N <br /> �ta5�3�z a�sa <br /> I CONTA.UCENSEN I <br /> Na�D riqr-�-5 Q7 �-la� e rnarin �� r � � � <br /> I U S E O F BUILDING HEqT SOURCE CONTRACT PflICE OF WOflK I <br /> � <br /> I �j� J � � _Eleciric _Gas_Other �Ob p� � <br /> WOR E-SCRIPTION I <br /> � <br /> j �e�ztir W0.11 ��ram�Y�� . Sfdir�q � On..�v�0.11 , ingl,�la-h'bl�la- DCCK�r�c� I <br /> I �ama col r3� �rc . `� J <br /> I No. PL BING MECHANICAL � <br /> iYPE OF�IXTURE Op ITEfd i <br /> I N�• TYPE OF FIXTl1qE OR 17[R7 <br /> � ._ Batlletub _ a'C–av handling units � <br /> i � Lavalory(wash basln) = Forced alr systems I <br /> Shower Gas plping <br /> ICitchen sink&d�spocal Nlaier heater I <br /> � Oishwasher _ Gas Iheplace I <br /> i � Clothes washer _ Gas�ange <br /> � VJalcr heaier Gothes dryer I <br /> I = Sink(service/baNmop/etc.) = Range hood <br /> Unnai�ow preventer � Exhaust fa�n <br /> Hpet pum <br /> � DnNcing Fountain _ UNt heater <br /> � _ Floor draln .._ Boiler <br /> � ,._ Greasa trap — Felrigeralion I <br /> Rool drains Woodstove I <br /> i _ Other _ = 01hCr — I <br /> � � <br /> I GTY OF[VERE?T LOCAL SALES TAX COOE IS 3105 I <br /> � I hereby ceritity that I have read end examined ihis applicailon antl know the same lo be erue ar,d covect. All provisions of laws and I <br /> I ordinaces goveminp this type oi work wlll be compliecl with whether speci�ied herein or not The grantlnp ot a permit does not presumo <br /> I to giva authority to vlolate or cancel tha provislon of any other state or lor,al law�egulating conslrucGon or the pertoRnance ol ! <br /> ConStruClion.Th2t 1 am Pulhorized by lhe owner ot Ihis property to peHorm the work br which applicatlon is made 2nd I Comply wifh fhe I <br /> I Stale itr�Gor; le v 1827 RCVJ and 296.200 WAC. <br /> � �/��r�L�'!=�-�`�� '� ` ` � l�/(J/ ��� I <br /> i S�gn3turc ol�Ovrfer�c.ontracroriFluthorizetl Agent Oate <br /> I I <br /> L— _ I <br /> I <br />