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Sent By: HP LaserJet 3700; 4258249516; Dec-12-05 71 :35AM; Page 2/2 <br /> � <br /> P�RMIT APPLiCATION <br /> ���� CITY OF EVERHTT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE7T, WA 98201, 425-257-8810 <br /> CL ClUS <br /> SlTE AOPRESS PARCEL TAX I.D.�t PERMIT# <br /> RR29 EMFRSON PL,EVfi1ZLl I,WA 98208 O048250000Jti00 <br /> MGS� 1 -G <br /> LEGAL LOT NO. 8L4CK TRACT <br /> OWNER AODRESS PHONE <br /> GREENLUND,KIM�GRLY RR29 EME1tSON PL (qy5)29U-5699 <br /> • EVERL•TT, N'A 98208 <br /> TENANT NAME CONTACT MAME PHONE <br /> PAMF.I.nfITI,L 42$ 814-JI"24x131 <br /> CONTRACTOR ADDRESS CONTR.LICENSEN <br /> FASI'WA'I'FiR HF.ATHR CpMPANY 12601 132NU AVG NE NAS'1'WlICU52UP <br /> (411)814-3124 Kl1tKLANU, WA yNU34 02116/2007 <br /> PROPOSED USE OF BUILDING swiemp Mao��nice Addllion AT SOURCE <br /> PERMIT CombinaUon PhimElnp WORK N��tlon I�o�ria <br /> TYPE O�molilion sly�n T'�PE N�w �• <br /> R� Ir nl �r <br /> CONTRACT PRICE OF WORK 5349.00 CtiY OF EVERETT LOCAL SALES TAX CODEIS J105 <br /> WORK DESCRIPTION Remove/Replace Flectric R'arer Ileater <br /> pLUMBING ��;NANICAL <br /> OF NO. TYPE O i UR <br /> WATER CLOSlT _.___ A1C•AMANOLINO UNITS <br /> BATHTUY _,_�___ PORCED AIR SYSTEMS <br /> J LAVATORI' (WASM BASIN) ._� FiEAT PUMP <br /> l � 3lIOWER __ UNIT XEATERS <br /> KITCMEN SINK 8 OISPOSAL _.,__ CLOTMES DRYER <br /> OISNWASHER _. RANGE HOOD <br /> LAUNORYTRAY __�__ WATlRliFJ�TER <br /> CLOTHES WASHER __ METAL FIaEPLACEfSTOVE <br /> � URINAL ___ FIREPLACE INSERT <br /> DRINKIN6 FOUNTAIN _.____ GAS FIREPLACE <br /> � FLOOR DRAIN GAS FtpNOE <br /> BACKFLOW PRHVlNTER _.,_____ OAS PIPINO <br /> � SINK (8ERVICEIBARIMOP/ETC.) _.__ EXHAUST FAN <br /> � OTHER� _ _.��_ OT11ER_____—_—___– <br /> I HER[BY CERTIFY THA71 HAVE READ ANO E7UMINED THISAPLICATION ANG KNOW THE SAME TO BE TRUE AND CORRECT,ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVLRNING THIS TYPE O�WORYc WILL BE COMPLIEO WIMT WHETHER SPEC7fIED HEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUAIE TO GNE AUTH041TY TO VIpLnTE o4 CnNCEi TME PROVISiON OP ANY <br /> OTHEft STATE OR LOCAL LAW REGUI�TING CONSTRUCTION ORTME P�RF6RAl4NCE OF CONSTRUCTION.TMAT I AM AUTHORI2E0 <br /> 8Y TFiE OWNER Of TT11S PROPERTY TO PERFORM THE WORK FOR WH1CH PPPLICA710N IS MAOE AND 1 COMPLY WRH TNE STATE <br /> CONTRACTORS U�W 18.27 RCW ANp Y96,200 WAC. <br /> Sipnatura of OwnadContrrotorlAuthoris�d Apem �,,._::=�„�-: ���� <br /> �.•�-i �t:Y'' 12II2/2UU5 <br /> ui ni <br />