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F RMIT APPLICATKoN <br />/,- <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />C'K R58 <br />SITE ADDRESS <br />PARCEL TAX I.D.# <br />PERMIT# <br />5301 COLBY AVE UNIT 102, EVERETT, WA 98203 <br />00697500110200 <br />j�1Gy <br />LEGAL <br />LOT NO. <br />BLOCK (TRACT <br />DE <br />OWNER <br />ADDRESS <br />PHONE <br />NEFF, LENORE fi CI IARLIiS <br />5301 COL13Y AVE UNIT 102 <br />(360)653-7694 <br />. I;V1iRETT, WA 98203 <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />JOHN NEFF I <br />PANIELA HILL <br />425 814-3124 x133 <br />CONTRACTOR <br />ADDRESS <br />CONTR.LICENSE# <br />FAST WATER I(EATER COMPANY <br />12601 132ND AVE NE <br />FASTWI IC052DF <br />KIRKLAND, WA 98034 <br />02/16/2005 <br />PHONE (425)814.3124 <br />PROPOSED USE OF BUILDING <br />PERMITJHBulldii <br />pMachanica <br />Combination Plumbing <br />WORK <br />Addillon <br />AlleraUon <br />HEAT SOURCE <br />Electric <br />TYPE <br />Demolition Sign <br />TYPE <br />Naw <br />as <br />r r <br />Ra alnMalnl <br />other <br />CONTRACT PRICE OF WORK S349.00 <br />CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION Rcmocc/RcplaccElectric Water Ilcncr <br />PLUMBING <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />—----- <br />A/C-A/HANDLING UNITS <br />---- <br />BATHTUB <br />—----- <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />_____ <br />HEAT PUMP <br />_______ <br />SHOWER <br />___ <br />UNIT HEATERS <br />KITCHEN SINK & DISPOSAL <br />—_—__ <br />CLOTHES DRYER <br />DISHWASHER <br />__ _ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />—___ <br />METAL FIREPLACE/STOVE <br />URINAL <br />—__—_ <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />FLOOR DRAIN <br />____ <br />GAS RANGE <br />i <br />BACKFLOW PREVENTER <br />___ <br />GAS PIPING <br />SINK (SERVICE/BAR/MOPIETC.) <br />_____ <br />EXHAUST FAN <br />OTHER <br />OTHER_______ <br />1 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 HERE( <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED <br />BY THE OWNER OP THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 P.CW AND 296.200 WAC. <br />Signature of Owner/Contractor/Authorized Agent �% Date 01/15/2004 <br />U0.1 <br />