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fram: 11/12/2�D7 14:39 q415 P.002/D03 <br /> PERMIT APPLICATION 383947 <br /> ��� <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA98201, 425-257-8810 <br /> 425-257-8857FAX ��--1`$�� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITq <br /> fi932 CARSON RD,EVGRE7"I',WA 96203 00393300007100 <br /> 5��' Ill -� < <: <br /> LEGAL LOT NO. BLOCK ITRACT <br /> OWNER ADDRESS PHONE <br /> �vn,kr_NsoN, Mnitcnairr �4�� Cars�. �, L�r.��t�, W� +���3 �425)355-5290 <br /> TENANT NAME CONTACT NAME PHONE <br /> UAHLMAN,GBNISf Cerol Randeil 800-454-8955 x 733 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> PASTWATIiRHrATERCOMPANY 12601132NUAVENG pAST'1VWI19480C <br /> KIRKLANI),WA 9H03A 01/03/2009 <br /> 800-454-8955 <br /> PROPOSED USE OF BUILDING eunai�o M�chMI�Ca WORK Additlo� H T 9ouRCe <br /> PBRMIT G�mbin�tion Plumbin Allsratlon El�ctrle <br /> TYPE D�mollllon 81pn TYPE N�w aa <br /> R� �Ir ��nl Iher <br /> CONTRACT PRICE OF WORK 5349.00 CITY OF EVERETT LOCAL SAlE3 TAX CODEIS 3105 <br /> WORK DESCRIPTION Remove/Replace Glec[ric Wuter Ileater <br /> PLUMBING MECHANICAL <br /> OF FI%TU 1 EM O FI U R I E <br /> ___ WATER CLOSET ______ A1C•A/HANDLINO UNITS <br /> ___ BATHTU9 _�___ FORCED AIR SYSTEMS <br /> ____ LAVATORY(WASH BASIN) ____ HEAT PUMP <br /> __ SHOWER ___ UNIT MEATERS <br /> ___ KITCHEN SINK 8 DISPOSAL ,_�__ CLOTHES ORYER <br /> __ DISHWASHER __ _ RANGE HOOD <br /> _____ IAUNORY TRAY ____�__ WATER HFJITER <br /> __ CLOTHES WASHER ___ METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE iNSERT <br /> _ DRINKING FOUNTAIN �_ OA8 FIREPLACE <br /> FLOOR DRAIN GAS RANOE <br /> _ BACKFLO�Y PREVENTER OAS PIP�NO <br /> __ SINK (SERVICE/BAR/MOPIETC.) ___ EXHAU3T FAN <br /> OTHER __ ______ OTHER_______�_ <br /> I NEREBY CERi1FY THAT I HAVE READ AND EXAMINEO THIS APLICATION AND KNOW TIIE SAME TO BE TitUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDIMANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED WIHT WHETHER SPECIFIEO MEREI <br /> OR NOT.THE GRANTING OF A PERMI7 DOES NOT PRESUME Tn GN[AUTHORI7Y 10 VIOLATE OR CANCEI THE PROVISION OF ANV <br /> O1HER STATE OR LOCl�L LAW RECiULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT IAM AUTHORIZED <br /> BY THE OWNER OF THIS PROPEKTY TO PERFORM THE WORK FOR WMICH APPLICATION IS MADE AND I COMPLY WITN TNE STATE <br /> CONTRACTORS LAW 18,27 RCW ANU 29820�WAC. <br /> Slgnawro of OwnodConlrectorlAuthorliad Agant �;�-0�y��f�,��r1p D�te ����ZR007 <br /> / <br /> ui.ai <br />