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I-r-Oro <br />12/19+/2009 11:31 #911 f'.002/002 <br />PERMIT APPLICATION 471280 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />SITE ADDRESS PARCEL TAX I.D,# PERMIT# <br />5301 COLBY AVE. P206, EVER1:1-I-, WA 9820 00697500120600 <br />LEGAL LOT NO. BLOCK TRACT <br />OWNER <br />ADDRESS <br />PHONE <br />ROBINSON, DIKE <br />5301 COLBY AVE `206 <br />(425)220-G274 <br />• EVr_RE1T, WA 98203 <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />Carol Randall <br />425-636-7054 <br />CONTRACTOR <br />ADDRESS <br />CONIR .LICENSE# <br />FAST WATLlt HEATER COMPANY <br />12601 132ND AVE NE <br />FASTWNV11948BC <br />425.636-7054 <br />KIRKLAND, WA 98034 <br />01/0,112010 <br />PROPOSED USE OF BUILDING Bulldlnp Mechanlca Addition HINT SOURCE <br />:PEPRMIT Combinalion ' Plumbing WORK Alteration lectric <br />Residential <br />YEDemotilian sign TYPE New ec <br />t Re air/Meint Cher <br />CONTRACT PRICE OF WORK $349.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION <br />Kcmocc/Rcplacc Electric Water Llcatcr <br />PLUMBING <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />NO, <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />____ <br />A/C-A/HANDLING UNITS <br />BATHTUB <br />_.._ __ <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK & DISPOSAL <br />_ <br />___ <br />CLOTHES DRYER <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />_ <br />] <br />WATER HEATER <br />CLOTHES WASHER <br />_ <br />METAL FIREPLACE/STOVE <br />URINAL <br />�_ <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />_ <br />GAS FIREPLACE <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFLOW PREVENTER <br />_ <br />GAS PIPING <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />OTHER <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 HERE It, <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AU1 HORITY TO VIOLATE OR CANCEL TI-!E PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHIM APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON7 RACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Signalura of Ownor/ContractorlAulhorizod Agent Ca cam . U GapP Date <br />12/1512009 <br />_ J <br />