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From <br />03/25�?011 12:10 �601 P.002/002 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />._ 3Z00 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />SITE ADDRESS <br />IGOG PUGE'f DR, HVEftli'I"1', WA 98203 <br />OWNER <br />SAN'I'OS, ANGBL <br />TENANT <br />CONTRACTOR <br />I�AS'1' WA'!ER HIiA'1'HR COMPANY <br />>RCEL TAX I.I <br />00393900600400 <br />ADDRESS <br />1606 PUGGC DR <br />• EVEREI"t, WA 98203 <br />CONTACTNAME <br />Carol Randall <br />ADDRESS <br />1260I 132ND A V G NL"• <br />425-636-7054 K1RKL.AND, \VA 98034 <br />PROPOSED U5E OF BUILDING ew�d�np M.o� <br />PERMIT Combination Plurt <br />Residential TypE o•mouuon g�Q� <br />r r <br />CONTRACT PRICE OF WORK CIT <br />WORK DESCRIPTION RemovcAtcplacc Blcctric Watcr lic;�tcr <br />WATER <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />I.AUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFIOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.j <br />OTHER <br />TYPE <br />✓"'� <br />Naw <br />533748 <br />3�as-I/ <br />PHONE <br />(425)353-10G2 <br />PHONE <br />425-636-7054 <br />CONTR.LICENS�# <br />fASTW1V11948I3C <br />01/04/2012 <br />�_�_ FORCED AIR SYSTEMS <br />—�__ HEAT PUMP <br />�__ UNIT HEATERS <br />_,__ CLOTHES URYER <br />_ _ _ RANGE HOOD <br />_� __ WATER HEATER <br />_`_ METAL FIREPLACE/STOVE <br />_�__ FIREPLACE INSERT <br />OAS FIREPLACE <br />GAS RANGE <br />__ GAS RIPING <br />___ EXHAUSTFAN <br />_ OTHER_��--�--�---,� <br />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />'ROVISIONS OF LAWS ANq ORDINnNCES GOVERNING TFi1S TYPE OF WORK WILL 8E COMPLIEO WIHT WHETHER SPECIFIEO HERE <br />)R NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br />)TMER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED <br />'�Y THE OWNER OF THIS PROPERTY 70 PERFORM THE WORK FOR WFiICH APPLICATION IS MADE AND 1 COMPLY WITH THE SiATE <br />:ONTRACTORS lAW 18.27 RCW AND 296.200 WAC. <br />Ignaturn of Ownor/Contractor/Authorized Agont <br />-- .. <br />Dato 03/22/20U <br />UI �:I <br />