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R^,RMIT APPLICATIt. N <br /> �i��r� CITY OF EVERETT PERMIT SERVICES <br /> `� 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> CK1839 <br /> SITE ADDRESS PARCEL TAX I.D.� PERMIT# <br /> 6b08 GATEWAY TER,EVERETT, WA 98203 00612000004100 m�y,z_oZ9 <br /> LEGAL LOT NO. BLOCK ITRACT <br /> DE <br /> OWNER ADDRESS PHONE <br /> WATSON,GLGN 6608 GATGWAY TER <br /> • BVGRGTT,WA 98203 (4Z5)353-4460 <br /> TENANTNAME CONTACTNAME PHONE <br /> PAMBLA HILL 425 814-3124 x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> PAS7'\VATER HEATER COMPANY 12601 132ND AVE NE FASTWHC052DF <br /> (425)814-3124 KIRKLA'ND,WA 98034 02/16/2005 <br /> PROPOSED USE OF BUILDING euna��o M�ohanica WQRK Addilion H AT SOURCE <br /> PERMIT Com6lnatlon Plumbinp Alt�ntlon I�ctrfc <br /> TYPE amolition Slpn TYPE N�w aa <br /> R� alrMlalnl er <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION Removc/Replace Gas Water Heater <br /> PLUMBING �,CHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM OF FIXTUR R ITEM <br /> __ WATER CLOSET ______ AIC-AIHANOLINfi UNITS <br /> ___ BATHTUB ��__ FORCED AIR SYSTEMS <br /> _�_ LAVATORY (WASH BASIN) _�_ HEAT PUMP <br /> �_ SHOWER ___ UNIT HEATERS <br /> ___ KITCHEN SINK 3 DISPOSAL _�_ CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY �__ WATER HEATER <br /> _ CLOTHES WASHER __ METAL FIREPLACE(STOVE <br /> _ llRINAL _�_ FIREPLACE INSERT <br /> _ ORINKING FOUNTAIN _ (iAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> �_ BACKFLOW PREVENTER __ GAS PIPING <br /> � SINK (SERVICFJBAR/MOP/ETC.) ___ EXHAUST FAN <br /> _ OTHER ______ OTHER_______�____�__ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAM�NED 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 COMPLIEO WIHT WHETHER SPECIFIED HEREI <br /> OR NOT.THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GNE AUTNORIN 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 OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.20�WAC, <br /> SlgnaWre of OwnedContraetorlAuthorized Ageni ��-�- �,-_��"�,�-- Date ����4/2004 <br /> UI_�/li <br />