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from: 10/�7/Z�07 11:27 �802 P. 002/002 <br /> PE�2MIT APPLIC�►TION 3816E"o <br /> ��i�,,, CITIf OF EVERETT PE�ZMlT SERVI�ES �� `�7 ` 67 <br /> 3200 CEDAR STREET, EVER�i'T, WA 9Pj201, 425-257-8810 <br /> aze-z5�-eas� r-fvc <br /> SITE ADDRESS PARCEL TI�X I.D.# PERMIT# <br /> 1003�AOLLY DRIVE N63,EVERET'T,WA 98204 00858500606300 ��� U 7 �U' v 3`'� <br /> LEGAL LOT NO. BLOCK TRACT <br /> D� <br /> QWNER ADDRESS PHONE <br /> DAVIDSUN,BRENDA 10030HOLLYDRIVE#63 �q25)347-34tQ <br /> • EVERETT,WA 98204 <br /> TENANT NAME CONTACT NAiVIE PHONE <br /> Carol Rancail 800-454•8955 x?33 <br /> CONTRACTOR ApDRESS CONTR.LICENSE# <br /> PAST WATER HL•ATER COMPANY 1260t 132NP AVF NE rASTW WH948DC <br /> KIRi{LAND,NA 98034 Ol/03/2008 <br /> 800-454-8955 <br /> PROPOSED USE OF BUiLDING ewm�np Mecnantce WORK Addltion HEAT SOURCE <br /> PERMIT Cambinallon Plumhlnp AltaraVan I�ctr�e <br /> TypE D�molltlon Siyn TYPE Now as <br /> ler Re alnTdeinl ther <br /> CONTRACT PRICE OF WORK �q49.00 CITY OF EVERETT LOCAL SALES TAIf CODEIS 3105 <br /> YVORK DESCRIPTION Remove/Replace Gns WaterHeater <br /> PLUMBING MECHANII:A� <br /> N . TYP OF FI TtJ E 1TEM O TYPE OF FIXTURE OR ITcM <br /> � WATER CLOSET __� AIC•A/HANDLING UN�TS <br /> _ BATHTUD __ PORCED AIR SYSTEMS <br /> ____ LAVATORY pNASH BASIN) ___ HEAT PU;7'r <br /> SHOWER UNIT HEATERS <br /> ____ KITCHEN SINK 8 DISPOSAL _,_ CLOTHES ORYER <br /> __ DISHWASHER ,, RANGE HOOD <br /> _ LAUNI�RY TRAY �1_ WATER HEATER <br /> CLOTHES WASHER �_ METAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> �RIKKING FOUNTAIN OAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> _ BACKFLOW PREVENTER _� GAS PIPING <br /> _ SINK (SERVICFJBARIMOPIETC,) EXHAUST FAN <br /> DTHER OTHER� <br /> � --- — .��- — - <br /> � <br /> I MEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APLICA710N AND KNOW THE SP."AE TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND OR`JlNANCES GOVERNING THIS TYPE OP WORK WILL BE COMPLIED WINT WHEiHER SPEGIFIED HEREI <br /> OR NOT.THE ORANTING OF A PERMIT DOE6 NOT PRESUME TO GIVE AUTHORITY TO VIOLA7E OR CANCEL THE PROb'ISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING COhSTRUCTION OR THB PERFORMANCE OF CONSTRUCTION.THATIAMAUTHORIZEO <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICAiION IS MAOE ANO I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 2�8200 WAC. <br /> Signaturo of OwnorfContraetorlAuthorized Agont �J�qy���,.�p Date 10,�17/2007 <br /> -- � / <br /> p�ors� <br /> �. ._.... .. ._�, .-.-. __.—_.—_ ._ �n .t . <br /> ...:. ....:i . . <br /> ...,y�:.�'Y.. <br />