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Pron: 17�01/2008 13:59 A015 P.003/003 <br /> ��RMIT APPLICATION 423'°Z <br /> ���� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201, 425-257-8810 <br /> 425-.'.57-8857 FAX ;2—a..{)� <br /> SITE ADDRHSS PARCEL TAX I.D.# PERMIT# <br /> 5825 i3ROADWAY,fiV6R&TT,WA 98203 28050500205200 \�1� ,, i ` ` � ; <br /> LEGAL 1.0T NO. BLOCK TRACT <br /> DE <br /> OWNER A�DRESS PHONE <br /> 5825 F3ROADWAY (425)348-9642 <br /> LAWRL•NCE,DL•E . L'VHItGTT,WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall 800-454-8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> PASTNATL-RIiGATERCOMPANY 12601132NDAVENE fAST11'WI{948�C <br /> KIRKLAND,WA 96034 Ol/04/2010 <br /> &00-454-8955 <br /> PROPOSED USE QF BUILDING Buudtnp M.eh,niu WORK �ddltlon Henr souRCE <br /> PERMIT Combination Plumhinp AlteraUon ElacMe <br /> 7yp� D�motition S�pn TYPE Naw as <br /> SorinMle R� alrlMalnt ther <br /> CONTRACT PRICE OF WORK a349.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORKOESCRIPTION Remove/ItcplaceGlectricWaterileatcr <br /> P U N� MECHANICAL I <br /> NO. E OF FI TU O I E O T E OF FIXTII R ITEM <br /> WATEF CLOSET �___ /UC-AIHANDLING UNITS <br /> BATHTUB _____ fORCED AIR SYSTEMS <br /> �__ LAVATORY (WASH BASIN) _ HEAT PUMP <br /> 5HOWER _� UNIT HEATERS <br /> KITCHEN SINK & DISPOSAL _ CLOTHES ORYER <br /> DISHWASHER RANGE HOOD <br /> � LAUNDI2Y TRAY 1 WATER HEATER <br /> CLOTHES WASHER � METAL FIREPLACEISTOVE <br /> URIIJAL ___ FlREPLACE INSERT <br /> DRINKING FOUNTAIN �__.__ OAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> � 31NK (9ERVICElBAR/MOPlETC.) _ EXHAUST FAN <br /> OTHER _ 07HER__ �____�___ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <br /> OR NOT.TME GRANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTNORITY TO VIOLATE OR 6ANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUC�fION OR TNE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOR¢ED <br /> BY THE OWNER OF Tt115 PROPERTY TO PERFOftM THE WORK FOR WHICH APPLlCAT10N IS MHOc AND I COMPLY WITN TME STATE <br /> CONTRAC70RS LAW 18.27 RCW AND 298.200 WAC. <br /> Signoturn of UwnorlContrectorlAulhariz6d Agent �,_�,y�7Cc�i„n(r.�'p �e�� ���01/2008 <br /> '"_ ' / <br /> u�oqI <br />