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Sent By: HP LasarJet 3100; <br />4258248510� <br />Apr•27-08 7:A7AId; <br />Page 5/5 <br />,r- �CRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />._� 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />oa��un <br />SITE ADDRESS PARCEL TN: I.D.p PERMIT# <br />�Ib � IABUC Hll. tVtllL• l�l. WA 98107 UU3920000bQ205 <br />_ m cxan5-o�� <br />OWNER <br />TAV>lEk, l.A`1A <br />ADDRES3 <br />.'.I G N CAI30T RD <br />LVIiRLTT, N'A y82U3 <br />TENANTNAME CONTACTNAME <br />1'AM�LA I�ILL <br />CONTRACTOR ADDRESS <br />i.45T N'�1T'ER HF.A fISK CUAIPANY 12G01 132ND AVH NG <br />(a?S)NIQ•31�4 h�kkf.ANT�, WA 9R034 <br />PROPOSED USE OF BUILDING ew�a�np � M�chanlc� WORI <br />hERMIT Combin■Ilon P;umhlnp <br />TYPE Dm�ollllon g,pn TYPE <br />CONTRACT PRICE OF WORK x449.00 CIiY OF �VERE <br />WORK DESCRIPTION ktmove,'F(eplece Gas N'nter Hcatcr <br />� <br />LAVATORY (WASH BASIN) <br />5MOWER <br />KITCMEN SINK 3 DISPOSAL <br />DISHWASHER <br />LAUNORY TRAY <br />CLOTHES WASMER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACNFLOW PREVENTER <br />SINK (SERVICElBAR/MOPlETC.) <br />OTMER___-___— _______—� <br />PHONE <br />(az5�t5)-oara <br />PHONE <br />425 814-3124 aIJJ <br />CONTR.UCENSE# <br />FAtiTl4'W'H9dBBC <br />01/0312008 <br />Nbr�llen <br />Nfw <br />90URCE <br />TAX CODE <br />A1C•A/HANDLINO UNITS <br />FORCEO AIR 9YSTEMS <br />MEAT PUMP <br />UNIT MEATERS <br />CLOTH�B OHYER <br />RANGE IIOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />6AS FIREPLACE <br />CAS FtANOE <br />(iAS PIPIN6 <br />FJ(IIAUST F/�N <br />OTH ER----------------- <br />^---I - - �------------- I - - � --_-----�-- ------ <br />i t�FRf�V CERTIFV THAT I �tAVE RGAO AND E%AMINL� THIS APUGATION AN ] KNOW 1HF SAME TO OE TRUE AND CORRECT. AlL <br />PRUVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS TVPE OF WUR'< WILL dE COMPLIEO WIMT WMETHER 5PECIFIED H[REIf <br />DR NOI. 7M6 GRANiING OF P. P[RMIT DOES NOT PRESUME TO (3NG AU7H� 1RITV TO VIp�ATE OR CANCEL T11E PROVISIOK OF ANY <br />DTHER STATF OH LOCAL LAW REC1ULAlINc3 CDNSTRUCTION OR TNE �LRFJRMANCE OF CON9TRUCTION. TMATIAM AUTHOR�2F0 <br />BY TME OWNER OF 7HIS PROP[RTV 70 PERFORM TNE WORK fOR WMICM 4PPUCATION IS MA�E nN0 I COMPLV WITM TME STA7E <br />�ONTRACTORR �-AW 1 B 77 qC W ANU 290.200 WAC. <br />naWro of Owner/ControatorlAuthorl:od Apeni �,...� �� ;.�„ �:'��. /.. - <br />� <br />D�te 04;27non� <br />w .v <br />