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Sent By: HP LaserJet 3100; 425824�516; Jun-1 -03 3:79Pl.1; Page 4/4 <br /> PE�' rtMIT APPLI�ATI4n1 <br /> ��i�� CITY OF EVERETT PERh'lIT SERVICES 6 �a -� <br /> 3200 CEDAR STREET, EVERE7T, '�NA 98201, 425-257-8810 <br /> U6UlU6 <br /> SITE ADDRESS PARC6L TAX I.D.# PERMIT# <br /> 3606NORTQNAVf,EVfiRM:I"f, 1VA 98201 OOt�I50Ua01 .00 ` <br /> / �'� ��,0' <br /> LEGAL LOT NO. BLOCK ITRACT `" <br /> DE <br /> OWNER ADDRE33 PHONE <br /> 360h NOR7'UN nve <br /> ROl'GR.G.4R1' (425)25g.2?1= <br /> • 6VLHGTT, 1�'A 9R201 <br /> TENANT NAME CONTACT NAME PHONE <br /> YAVIF.I.A HILL 425 814-31�4 �133 <br /> CONTRACTOR ADDRESS CONTR.UCENSE# <br /> FAST WATEF HLATF.R CU1'IPANY I�G01 I.i?\17 AVB\E I'ASTR'\VH9-ISBC <br /> (4^5)N�d•31?4 KIILKJ.AND. N'A 9$Q34 UIiU3'�003 <br /> PROPO5ED USE OF BUILDING euua�nfl ncacnanics WORK AQOIt{on HEAT SOURCE <br /> PERMIT CortIDlNtlon P�umElnp - IVUratlo� QElectric <br /> IYPE ��molition Sipn TYPE New as <br /> � r Re �INMalnl thar <br /> CONTRACT PRICE OF WORK gqq9.0() CITY OF EYERETT i.00AL SALES 7AX CODEIS 3105 <br /> WORK OESCRIPTION Remuvclkeplace G�.ti Wacer Ile;ucr <br /> PLUMBING MECHA ICAI � <br /> N4. TYP OF IXTURE OR ITEM TYPE OF FI%TURE OR tTEM <br /> ____ WATER GLOSE7 _______ A1C-A/HANDLING UNITS <br /> ___ BATHTU9 _______ FORCED AIR SYSTEMS <br /> ___ LAVATpRY (WASH BASIN) ______ HEAT PUMP <br /> __� SHOWER ____ UNIT HEATERS <br /> ____ KITCHEN SINK & DISPDSAL �__ CLOTHES �RYER <br /> ___„ DISHWASHER � _ RANGE HOOD <br /> „__ LAUNDRYTRAY _ �__ WATERMFATER <br /> __ CLOTHES WASHER �_ METAL FIREPLACEISTOVE <br /> T URINA� _^_ FIREPULCE INSERT <br /> __ DRINKING FOUNTAIN _�__ GAS FIREPLACE <br /> __, FLOOR DRAIN ___. GAS RANGE <br /> ___ BACKFLOW PREVENTER ___� GAS PIPING <br /> � SINK (SERVICEJBARIMOPlETC.y EXHAUST FAN <br /> _ --- <br /> -- --` <br /> __--_ OTHER_�____ —_- ---- OTHER___-------�-------_ <br /> 1 MERE6YCERTIFY THAT I HAVE READ AND EXAMINBD TNIS APlICATION A�10 KNOW THE SAA1E TO BE TRl1E ANp CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 1YPE OF WOFI(WILL BE COMPLIEo \YIHT WHETHE175PECIF�ED H[REI <br /> OR NOT.tHE GMNi1NG OF A PERMIT DOES NOT ARESUME TO GNE AUTi-ORITY TO VIOLATE OR CANCEL THE CROVI510N OF ANY <br /> OTMER STAT[OR LOCAL L./\W REGULATING CONSTRUCTION OR THE PER�°ORMANCE OF CONSTRUCTION.THqT I AMAUTHOR12E0 <br /> UY THE OWNER OF TIIIS PROf'ERTY TO PERFORRI 7HE WORK FOR WHICF�APPLICATIOY 1S MADE AND I COMPLY WITM THE STATE <br /> CONTRAGTORS LAW 18.27 RCW AND 2Dfi200 WAC. <br /> SignaWre o( OwncrlCantraclorfAuthorixod Agcni ,.__ �.,— � ::'r �. Date U6������06 <br /> w� �ni <br />