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From: � 06/1�"?010 07:54 p515 P.002/005 <br /> PERMIT APPLICATION 493357 <br /> ��i�� CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 "� <br /> 425-257-8857 FAX 6/�-�(/ <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI'1"�► <br /> 126 FOREST CT,EVERETT,WA 98203 00850300000200 ` �� _ I <br /> LEGAL LOT NO. 6LOCK TRAC'i <br /> OWNER ADDRESS PHONE <br /> DUTTON,DAWN 126 FOREST C7' <br /> • EVERETT,WA 98203 (425)303-8407 <br /> TENANTNAME CONTACTNAME PHONE <br /> Cerol Randali 425-636-7054 <br /> CONTRACTOR ADDRESS CONTR.LICEKSE* <br /> FAST PlATER HEATER COMPANY 12601 ]32ND AVE NE <br /> FAST W WH948SC <br /> 425-636-7054 �KLAND,WA 98034 Ol/04/2012 <br /> PROPOSED USE OF BUILDiNO euildtnp M�ehanioa pddition T SOURCE , <br /> PERMIT Combin�tbn Plumbl� WO� Nlantlon ENetric <br /> Residential 'rypE D�mo011on gipn TYPE � �� <br /> W �INMa�nt � <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EYERETT LOCAL SALES TA�C CODEIS 3105 <br /> WORK DESCRIPTIDN Remove/Replace Ges Water Heatcr <br /> PLUMBING MECHANICAL <br /> OF U I p p <br /> ____ WATER CLOSET A/C-AIHANDLIN(i UNITS <br /> --__ BATHTUB FORCED AIR 3YSTEMS <br /> - --- LAVATORY(WASH BASIN) --- HEAT pUMP ' <br /> SHOWER UNIT HEATERS <br /> _ KITCHEN SINK 6 DISPOSAL CLOTHES DRYER <br /> _ DI:HWASHER + � RpNGE HOOD <br /> _�_ LAUNDRY TRAY 1 WATER HEATER <br /> ___ CLOTHES WASHER METAL FIREALACE/STOVE <br /> _ URINAL � FIREPLACE INSERT <br /> ___ DRINKIN6 FOUNTAIN � pA8 FIREPLACE <br /> FLOOR DRAIN GAS RANOE <br /> _____ BACNFLOW PREVENTER OAS PIPW6 <br /> _� SINK (SERVICElBARIMOP/ETC.) EXHAU3T FAN q� <br /> _�_ OTHER _ OTHER_ _ <br /> t HEREBY CERTIFY THAT I NAVE READ AND EXAMINE�THIS API.ICATION AND KNOW THE SAME 70 BE TRUE AND CORRECT.ALL <br /> PROVISIUNS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <br /> OR N07.TME GRANTiNG OF A PERMIT DOES N07 PRESUME TO ONE AVTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR T11E PERFORMMCE OF CONSTRUCTION.THA71 AM AUTHORIZED <br /> BY THE OWNER OF TMIS PROPERTY TO PERFORM THE WORK FOR WHICM APPLICF�TION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONiRACTORS LAW 18,27 RCW ANO 298.200 WAQ _ __ , .�, _ _„�,�, .. <br /> Siynaturo ot Owner/Contr�ctorlAuthorizad Ayent �9 jay,q,.���,�nP Dats OS/25/2010 <br /> ---- � / <br /> u�.ai <br />