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Sent By: HP LaserJet 3100; 4258249516; Jan-2=-OE 10:38Ah�; Page 3 <br />� <br />,.- �Cf�.MIT APPL�CATlON <br />f���� CITY OF EVER�TT PER�VIIT S�RVICES <br />F 3200 CEDAR STREET, EVERETI-, WA 98201, 425-257-8610 <br />u i 3aor, <br />SITE ADDRES5 PARCEL TAX I.D.# PERMIT# <br />s7241.OWlLL RD. F.VFRE'1'!', WA 98?U5 OW95gUU40 Q06 rn �(00 (-Q(p� <br />�LLLIJ'I', R()R1N <br />5724 LOWRLL Rll <br />rVCRF.TT. WA Y821)3 <br />PAMELA HII.I. <br />CONTRACTOR ADDRESS <br />FnST WATER HGA'I'ER CUN�I'ANY 1?601 132ND AVE NE <br />PHONE (425)StA•3124 �IRI:LAND, WA 98034 <br />PROPOSFtJ U.S�E OF BUILDING ewminp Mae'hi..�ea <br />PBpMIT CombinaUan P umbinp WORI <br />7yp� Dama�uon egn TVPE <br />� W�K 5349.00 <br />WORK DF.SCRlPTION Remove/Repince Elccvic Water lleater <br />� <br />WATER CLOSET <br />BATlITU9 <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCNEN SINK 8 DISPOSAL <br />DISk:YASMER <br />LAUN�RY TRAY <br />CLOTIIES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLooP, DRAIN <br />BACeCFl,OW PREVENTER <br />SINK {SERVICEIBAR/MOP/ETC.) <br />9THER _� <br />�HONE <br />(q2c)348-5202 <br />425 RIS-�124 x133 <br />CONTR.LICENSE# <br />1'ASTW wri9a8ttC' <br />01/03/20U8 <br />Nterotlon <br />N�w <br />TAX <br />._____ FORCEO AIR SYSTEMS <br />.�_ HfiAT PUMP <br />._` UNI7 HEATERS <br />_ __ CLOTHES DRYER <br />_ RANGE HOOD <br />_ l , WATER HEATER <br />___^_ METAL FIREPLACElSTOYE <br />____ FIREPLACE INSERT <br />____�_ GA8 FIREPLACE <br />__` GAS RANGE <br />__„� OAS P�PING <br />_�_ EXHAUST FAN <br />_`__ OTHER_ _�___.__—_ . <br />� <br />I HEREBYCERTIFYTHAT I HAVE READ AND EXAMINED THIS APLIGATION.UIU KNOW THE SAME TO BE TRUE AND CORREC7, qLL <br />PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS 7vPF �F WORF. WIL� 8E coMaL1ED WIHT WHETHER SPEGFIcO HEHE <br />OR NO? THE GRANTING OFA PERMIT DOES NOt PRESUME TO GNE AUTHCRITY TO VIpLATE OR CANCEI 7H6 PROVISION OF ANv <br />OTHER STATE OR LOCAL LAW REGULATING CONSI"RUCTION ORTME PERF�)RMANCE OF CONSTRUCTION. THAT I AMAUTHORIZEO <br />Bv 7HE OWNER OF THI3 PROPERTY TO PERFORM THE WORK POR WHICN FPP�ICATION IS tvuoE AND 1 COMPLY W�Tn TnE STnTE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br />--- - - <br />otOwnadContrectorlAuthorizedAgeni �.�:::�1;� �,,,;;;:'�:,�--• �ate UI/?4r200G <br />U�J31 <br />