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�'ERI�AIT APPLICA� �ON <br /> � C�TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> SITE ADDRESS 017721 <br /> PARCEL TAX I.D.# PERMIT/ <br /> 10919 EVERGREEN WAY,EVERETT,Wp 9g2p4 ppqqZqpp�01101 <br /> LEGAL LOT NOa M o3�3-a�� <br /> B�C�K TRAC7 <br /> OWNER ADDRESS — <br /> MINI U STORAGE 109I9 EVERGREEN WAY PHONE <br /> • EVERE7"f, WA 9820q (425)347-2420 <br /> TENANT NAME CONTACT NAME <br /> PAMELA HILL PHONE <br /> CONTRACTOR a25 814-3t24x133 <br /> ADDRESS CONTR.LICENSE�R <br /> FAST WATER HEATER COMPANY 12601 132ND pVE NE <br /> KIR]CLAND,Wp 98034 FASTWHC052DF <br /> (425)814-3I24 02/16/2005 <br /> PROPOSED USE QF BUILDING ewia�o M,��,,,,��, �i� <br /> PERMIT Combinrdoa Plumbinp W�RK N�� H T SOURCE <br /> TYPE WmoIIWn gb� nPE � Netrlc <br /> � <br /> CONTRACT PRICE OF WORK 5349.00 � �"� � <br /> CI7Y OF EYERETT LOCq��µEa Tqx CODEIS 3105 <br /> WORK DESCRIPTION <br /> Remove/Replace Elcctric Water Heater <br /> PLU� OF TU � MECH--'4�A� <br /> ,__ WATER CLOSET �- R ITEM <br /> —___ BATHTUB ----- N�'�NDLING UNITS <br /> --_�_ LAVATORY�VIIqSH BASIN) --- FORCED AIR 8ySTEIMg <br /> _ SHOWER --- HEAT PUMP <br /> _____ KITCHEN SINK d,OISPOSAL --- UNIT HEATERS <br /> ____ DISHWASHER --- CLOTNBS DRYER <br /> —____ LAUNDRY TRAY � - RANGE HOOD <br /> ____ CLOTHES WASHER - INATER NEATER <br /> —_ URINAL -- M�1� FIREPLACElSTOVE <br /> _ DRINKING FOUNTAIN - FIREPLACE IN8ERT <br /> FLOOR DRAIN - �$ F�REF'uCE <br /> —____ BACKFLOW PREVENTER �s �aE <br /> �_ SINK (SERVICEIBAR/!dOP,'ETC.) �S PIPWO <br /> � OTHER --- EXHAU8T FAN <br /> — --_ OTHER <br /> — � — --- -----__— � <br /> 1 HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS APLICATIpN A,ND KNOW THE SAME TO BE TRUE AND CORREC7.ALL ' <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPEGFIED MEREI I <br /> OR NOT.THE CiRANT�NG OF A PERMIT DOES NOT PRESUME TO ONE AUTHORITY TO VIOI.ATE OR CANCEL THE PROVISIpN OF A1ry <br /> OTHER STATC pR�pCq��qyy REGULATING CONSTRUCTION OR TNE PERFORMIW�E OF CONSTRl1CTqN.TMA71 MA AUTHpItIZED <br /> BY THE OWNEA OF THIS PROPERTY i D PERFORM THE WORK FOR WHICH App��CqnpN�g MApE AND 1 COMP�Y WITl1 THF STATE <br /> CONTRACTORS LAW 18,27 RCW AND 298.200 WAC. <br /> Siynature of OwnedContpctor/Authorized Apem �. Dab <br /> ��—��'��� 03/06/2003 <br /> tll_ql <br /> � . I <br />