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From: 01I�+ �2011 10:45 #708 P.002I004 <br /> i <br /> PERMIT APPLICATInN 524047 <br /> ���� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 , 425-257-8810 <br /> 425•257-8857 FAX /— //��� <br /> SITE ADDRESS PARCEL TAX I.D.M PERMITA� <br /> 4827 AI.C,CH AVE, C•Vf:RLTT, WA 982U3 0061 I IOOOOBUOU <br /> � / /� ( - 0 /� <br /> LEGAL LOT NO. BLOCK TRACT <br /> OWNER ADDRESS PHONE <br /> JUIiNSON, VGftNE& LINDA(D1'N) NU�'M���" (425)252•2G73 <br /> TENANTNAME CONTACTNAME PHONE <br /> Carol Randall 425-636-7054 <br /> CONTRACTOR AODRESS CONTR.LICENSEK <br /> FAS'I'WA"fC•R H[ATER CUMPANY 12601 132ND AVE NG PASTW WH94611C <br /> 425-636-7054 h�kKLAND,WA 98034 UI/04/2U12 <br /> PROPOSED USE OF BUILDING sulmtny M•en.nio• WORK Adawon H T souRCE <br /> PERMIT Com6lndlan YIum0lnp Nl�ntlon I�elAc <br /> Residential TypE D�mollUon slpn T�PE N�w �� <br /> p NrIMYnI 11� r <br /> CONTRACf PRICE OF WORK CITY OF EVERETT LOCAL lALES TAX CODEIS ]105 <br /> WORK DESCRIPTION �tcmovc/Replacc�us W�tcr Ilcutcr <br /> PLUMBING INECHANICAL <br /> U I � <br /> ___ WATER CLOBET ______ AIC•AlHANDLINO UNITS <br /> _____ BATMTUB �_____ PORCED AIR SYSTEMS <br /> __ LAVATORY(WASH BASIN) ��_ HEAT PUMP <br /> ___ SHOWFR ___ UNIT HEAT[RS <br /> ___ KItCHEN SINK 8 OISP08AL ____ CLOTNFS ORYER <br /> ___ OISHWASHER _ RANGE HOOD <br /> ___ IAUNDRY TRAV � _ WATER HEATER <br /> _�_ CLOTHEB WASHER _�,__ METAI FIREPLACFJSTOVE <br /> � URINAL ____ FIREPLACE INSERT <br /> _ DRINKINIi FOUNTAIN _�_ OAs FIREPLACE <br /> _ FLOOR DRAIN _� OAS RAN(iE <br /> ___ BACKFLOW PREVENTER _�, OA3 �IPIN6 <br /> _, SINK (SERVICElBAR/MOP/ETC.) �__ EXHAU8T FAN <br /> _�_ OTHER _�_ OTNER_^_�_�____,�__ <br /> I MEREBY CERTIFV THAT 1 MAVE READ ANO EXAMINEO THI9 APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl � <br /> PROVIStONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL 6E COMP�IED WIMT WHETHER SPECIFIEO MEREI <br /> OR NOT.THE ORANTINO OF A PERMIi DOES NOT PRESUME TO ONE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR IOCAL lAW REGULATING CONSTRUCTION OR TME PERFORMANCE OF CONSTRUCTION.THATI AMAUTMORIZED <br /> 8Y THE OWNER OF THIS PROPERTY TO PERFORM 7NE WORN POR WMICN APPLICATION IS MAOE AN01 COMPLY WITM TNE STA7E <br /> CONTRACTORS LAW 1B.Y7 RCW AND 298.200 WAC. <br /> Sipnalun of OwnedContnclorlAuthori:�d Apent �,,���,f�,,,,�p D�b OI/I I/20I I <br /> ul_MI <br />