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( 'ERMIT APPLICA� .�N <br /> �i���� CITY OF EVERETT PERMIT SERVICES <br /> '� 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 019106 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITit <br /> 2921 PANAVIGW BLVD,EVGRETT,WA 98203 00603700012600 <br /> mo3�o -0�6 <br /> LEGAL LOT NO. BLOCK TRACT <br /> OWNER ADDRESS PHONE <br /> PRIEST,JOHN Z921 PANAVIEW HLVD <br /> • EVERETT,WA )8203 (425)355-2621 <br /> TENANT NAME CONTACT NAME PHONE <br /> PAMELA IiILL 425 814-3124 x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> �AST WATGR HEATER COMPANY 12601 132ND AVE NE <br /> FASTWHC052DF <br /> (425)814-3124 KIRKLAND, WA 98034 02/16/2005 <br /> PROPOSED USE OF BUILDING euudtnp M�chsnla Additlon H T SOURCE <br /> PERMIT Com6lnallon Plumbiny WORK N��ratlon NcMc <br /> TYPE D�molilton 319n T�'PE New aa <br /> CONTRACT PRICE OF WpRK � R� �IrlMalnt e� <br /> 5449.00 CITY OF EVERETT LOCqL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION <br /> Rcmuvc/Rcplacc Gas 1Vutcr Hcatcr <br /> M BI MECHANICAL <br /> U• TYPE OF FIXTURE O ITEM OF IXTUR R ITEM <br /> ___ WATER CLOSET AIC•A/HANDL�N6 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 TFtAY � WATER HEATER <br /> ____ CLOTHES WASHE.t METAL FIREPLACE/STOVE <br /> ___ URINAL FIREPLACE INSERT <br /> ___ DRINKING FOUNTAIN � (3AS FIREPLACE <br /> ___ FLOOR DRAIN GAS RANGE <br /> _____ BACKFLOW PREVENTER GAS PIPING <br /> �_ SINK (SERVICEIBAR/MOP/ETC.) EXHAUST FAN <br /> _�_ OTHER_ _�_ OTHER___�_____� <br /> I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED WIHT WHETHER SPECIFIED MEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISqN OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THATIAMAUTHpRIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TME STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Stgnature o(OwnedControctor/Authorized Agem �� �` � p��� <br /> �'�� 10/07/2003 <br /> UI.V11 <br />