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From: 06/OB/2009 11:44 R826 P.002/002 <br />. � , <br />PERMIT APPLICATION �5213 <br />�CITY OF EVERETT PERMIT SERVICES <br />3�00 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />SITE ADDRE53 PARCEL TAX I.D.# PERMIT# <br />3211 GRANll AVE #1, EVERETT, WA 98201 00437577000500 .� <br />- , <br />LEGAL LOT NO. BLOCK ITRACT <br />OWNER ADDRE38 PHONE <br />COLDWELL BANKERBAIN �Z�ZI BEL-ItED RD STE#1 <br />• B�LLEVUE, WA 98005 (360)652-4026 <br />TENPNTNAME CONTACTNAME PHONE <br />wu1.x.LEBEN, LAURA Carol Randall 425-636-7054 <br />CONTRACTOR ADDRESS CONTR.LICENSE� <br />PASTWATERHEATERCOMPANY 12601 132NDAVENE FASTWWH948BC <br />425-636-7054 KIRKLAND, WA 98034 Ol/042010 <br />PROPOSED'JSE OF BUILDINO °°11e1"o �h'"�" WORK Addltlon H T souRCE <br />PERMIT Combin�tlon PIum0lnp Nuntlon Isctrlc <br />TYPE D�maltlon g�p� TYPE N�w as <br />� ° R� IrlMalnl r <br />CONTRACT PRICE OF WORK S349.00 CIiY OF EVERETT LOCAi SALES TAX CODEIS 3105 <br />WORK DESCRIPTION Remove/Replace Electric Water Heater <br />PLUMBING MECHANICAL <br />O. PE OF F TU 1 E FI URE OR ITE <br />_�_ WATER CLOSET _ NC-AIHANDLIN6 UNITS <br />___ BATHTUB _�__ FORCE� AIR SYSTEMS <br />__ LAVATORY (WASH BASIN) HEAT PUMP <br />__�_ SHOWER ___ UNIT HEATERS <br />_„___ KITCHEN SINK 6 DISPOSAL ___ CLOTHES DRYER <br />DISHWASHER _ _ RANGE HOUD <br />__^ LAUNORY TRAY _____i _ WATER HEATER <br />_�_ CLOTHES WASHER ___ METAL FIREPWCEISTOVE <br />_ URINAL _ FIREPLACE INSERT <br />�_ DRINKING FOUNTAIN _ OAS FIREPLACE <br />_ FLOOR DRA1N _ 6A9 RAN(iE <br />__ BACKFLOW PREYENTER QAS PIPINO <br />� SINK (SERVICEJBARIMOP/ETC.) ___ EXHAUST FAN <br />_.�_ OTHER _ OTHER_�,_ <br />I HERE6V CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL^ <br />,�ROVIS�NS OF �AWS AN� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <br />�OR NC�T. THE GRANTING OF A PERMIT DOES NOT PRESUME TO ONE PUTHORITY TO VIOLATE OR CANCEL THE PftOVI510N OF ANY <br />Ol'NER STATE OR LOCAL LAW REGUTATING CONSTRUCTiON OR THE PERFORMANCE OF CONSTRUC'170N. THAT I AM AUTMORIZED <br />BY T:1E OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH AppLICATION 18 MA�E AND 1 COMPLY WITH TNE STATE <br />CONTFtACTORS LAW 18.27 RCW ANO 296.20D WAC. <br />Sipneturo nf Owne�/CantractorlAutho�izad Agent n'I���,��P Dat� Q6/OSl2009 <br />—�---- f <br />m �ni <br />