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P' :RMIT APPLICATILN <br /> ���� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAi2 STREET, EVERETT, WA 98201, 425-257-8810 <br /> CK1415 <br /> SITE ADDRESS PARCEL TAX I.D.X PERMIT� <br /> 4729 F3AYVIGW LN, GVGR�TT,WA 9R203 0041700U400300 <br /> rno�c��-0�3 <br /> LEGAL LOT NO. BLOCK TRACT <br /> OWNER A09RESS PHONE <br /> MICHAEL,JAM@S 4�z9 f3AYV18W LN <br /> • CVERHTT,WA 98203 (4Z5)?55•7674 <br /> TENANT NAME COFITACT NAME PHONE <br /> PAMI'sLA Ii1LL q25 814-3124 x133 <br /> CONTRACTOR ADDRESS CONTR.:ICENSEN <br /> 3AST WATHR HGATC:R C'OMPANl' 12G01 1321JD AVG NB fASTWHC05'tDP <br /> (425)R14-3124 KIRKLAND,WA 9R034 02/IG/2005 <br /> PROPOSED USE OF BUILDING ewm�np M�ob�n�ea �edltion H T L'OURCE <br /> P[RMI7 Combindion PIum6lnp WORK N��ntlon qetdo <br /> TYPE D�moliUon g�p� TYPE N�w <br /> aa <br /> CONTRACT PRICE OF WORK Ru �IrlM�ln� her <br /> 5449.00 CITY OF EVERETT LOCAL SALES'fA7I COOEIS �105 <br /> WORK DESCRIP710N Rcntovc/Rcplacc Gas Wnicr Ilcatcr <br /> PLUMBING MECHANICAL <br /> OF TU I E OF 'XTUR� R I E <br /> _____ WATER CLOSET A/C•A/HANDLINO UNITS <br /> _—___ BATHTU9 FORCED AIR SYSTEMS <br /> _______ LAVATORY (YIIASH BASIN) � HEAT PUMP <br /> v_ SHOWER UNIT MEATERS <br /> —____ KI7CHEN SINK 6 DISPOSAt. CLJTHES DRYER <br /> ___�_ DISHWASHER RANGE HOOD <br /> ______ LAUNORY TRAY � WATER HEATER <br /> _�__ CLOTHES WASHER METAL FIREPLACE/STOVE <br /> ____ URINAL � FIREPLACE INSERT <br /> ___ DRINKING FOUNTAIN � OAS FIREPLACE <br /> FLOOR DRAIN GAS RAN(iE <br /> _�__ BACKFLOW �REVENTER ~� GAS PIPINO <br /> ___ SINK (SEP,VICFJBAR/MOP/ETC.) EXHAJST FAN <br /> ---- 07HER---- -- _�_ OTHER_��------�-� <br /> 1 HEREBY CERiIFY THAT 1 HAVE READ AND EXAMINED THIS NpLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi.ALL <br /> PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE OF WORK WILL 6E COMPLIED W�HT WMETHER SPECIFIED MEREI � <br /> OR NOT.TME GRANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTMORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL UW REGULATING CONSTRUCTION OR TME PERFORMANCE OF CONSTRUCTqN.TMAT IAMAUTHOR¢ED <br /> B'/THE OWNER OF THIS PROPERTY TO PERFORM TME WORK FOR WMICH APPL�CATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Slpnature of OwnedContnetorlAulhorized Ayem ��-/Gv �lG�_� Dat� <br /> 08/10/2004 <br /> u�ai <br />