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I�LRMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 647G57 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 216 BRIDGG VAY,EVERETT,WA 98201 00520300003200 <br /> LEGAL LOT NO. BLOCK ' Uao( — <br /> p ITRACT <br /> OWNER ADDRESS PHONE <br /> VAUHAN,GERTRUDE 6403 BROOKLYN NE <br /> • SEATTLE,WA 981IS (Z�6)522-0018 <br /> TENANT NAME CONTACT NAME <br /> ARELLANO,GAYLE PAMELAHILL qPHOg E3144x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> PAST WATGR HEATER COMPANY 12601 132ND AVE NG <br /> FASTNHC052DF <br /> (425)814-3124 K1EtKLAND,VVA 98034 02/16/2002 <br /> PROPOSED USE OF BUILDING Bu11dino M�chaniu nddtt�on H AT SOURCE <br /> PERMIT Combinallon P�umbinp WORK /UqraBon El�etrie <br /> TYPE D�molitton Slyn TYPE N�N, <br /> as <br /> CONTRACT PRICE OF WORK R' '�'�'�"� �her <br /> S349.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION Rcmm�c/Rcplacc Elcctric WatcrHcatcr <br /> UMBI MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM O. OF FIXTUR OR ITEM <br /> __�__ WATER CLOSET A1C•AIHANDLING UNITS <br /> —___ BATH7UB FORCED AIR SYSTEMS <br />' ___�__ LAVATORY �AIASH BASIN) � HEAT PUMP <br /> __�_ SHOWER UNIT HEATERS <br /> —____ KITCHEN SINK 6 DISPOSAL � CLOTHES ORYER <br /> _____ DISHWASHER � RANGE HOOD <br /> ____ LAUNDRY TRAY � WATER HEATER <br /> _�__ CLOTHES WASHER METAL FIREPLACElSTOVE <br /> ___ URINAL FIREPLACE INSERT <br /> _____ DRINKING FOUNTAIN GAS FIREPLACE <br /> ___ FLOOR DRAIN GAS RANGE <br /> _____ BACKFLOW PREVENTER GAS PIPING <br /> _____ SINK (SERVICEIBAR/MOPfETC.) EXHAUST FAN <br /> ____ OTHER _,_ OTHER___r_____�_____ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <br /> OR NOT.THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION Of ANY <br /> OTHER STATE OR LOCAL lAW REGULATIMG CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18,27 RCW AND 296.200 WAC. <br /> Sipnatura of OwnedContractodAuthortzed Ageni ,,�-��� '" Date <br /> � �–��'%' 12/24/2001 <br /> UI.MI <br />