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Sent By: HP LaserJet 3700; 4258249516; Apr-12-O6 B:26AA1; Page 5/6 <br /> ,.- PEk,�IIT APPLlCATION <br /> �1��� CITY OF EVERETT PERIIAIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> o�t:uF <br /> SITE ADDRESS PARC6L TAK I.D.# PERMIT# <br /> 10305 MERIPIAN AVE,EVEhETT, WA 9820R 0039G90000 W01 rllDl�D � �. <br /> LEGAL LOT NO. BLOCK �7RACT <br /> E <br /> OY�NER ADDRESS PNONE <br /> 10305 MF.RIDIAN AVE (42i)347-4G96 <br /> RUI1rRTS,JA\CT �VE�.i,.�. H,p �g20g <br /> TENANT NAME CONTACT NAME PWONE <br /> PAMELA Hll.l. 425 814-,i 124 xl3i <br /> CONTRACTOR ADDRESS CONTR.LICENS�� <br /> FAST\VAl'�R HFATER COMPANI' 12601 132ND AVENE FAST\YWI1946RC <br /> (425)81a-312d KIEtKi.AND, \VA 9R037 Ull032UU8 <br /> PROPOSED USE OF BUILDING Bulldinp Mechsnica WORK Ada�tlon NEAT S011RCE <br /> PERMIT Comb�n�tbn �'lum�lnp • Nl�ration El�etrlc <br /> IYPE Mtndilian :ilpn �PE N� aa <br /> R� WyMalnt tner <br /> CONTRACT PRICE OF ViIORK 544y.UU CITY OF EYERETT LOCAL SALES TA7(CODE�S �105 <br /> WORK DESCRIPTION Remuve/Repince Gas Water Hearer <br /> Mg� MF�HANICAL <br /> N TYPE OF FIXTURE OR ITE N�. OF IXTU R ITE <br /> WATER CLOSET ______ A1C•AIMANOLINO UNI75 <br /> �__ BATMTUB __�___ FORCED AIR SYSTEMS <br /> ___ 1JIVATORY (WASH 6A51N) ____ HfeAT PUMP <br /> SHOWER __...,_ UNIt HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL _, CLOTHES DRYER <br /> DISHWASH[R __ _ RANGE HOOD <br /> + LAUPIDRY TRAY __�_ WATER HFJITER <br /> � CLOTHES WASHER __�__ METAL FIREPIl�CE1STOV� <br /> URINAi _��_ FlREPLACE INSERT <br /> � ORINKING FOUNTAIN ,�_ GAS FIREPLACE <br /> FLOOR DRAIN _�_ GAS RANGE <br /> �� BACKFLQW PREVENT�R �___�_ GAS PIPING <br /> _� SINK (sERVICElBARIMOPIETC.) ___ EXHAUST FAN <br /> -- ' DTHER_�—_�. .._.� —_____ OTMER_----------------- <br /> 1 HER�BY CERTIfY THAT I HAV[REAU ANO EICAMINEp THIS APIICATION P.ND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS C�F LAWS AND ORDINANCES GOVERN�NG THIS TYP[OF WORK WILL BE COMALIEO WIHT WHETHER SPECIFIED MEREI <br /> OR NOT,hIE GRANTING OF A PERMII"OOES NOT PRESUME TO GIVE AUT�IORITY TO VIOLATE OR CANCEL THC PROVISION OF ANY <br /> OTHER STATE OR LOCAL lAW ItEGULATING CONSTRUCTION OR TNE PEF.FORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2E0 <br /> �Y THE OwNER OF TNIS PROPERiY TO PERFORM THE WORK FOR WHIC.i APPLICAT70N IS MADF. AND 1 COMPLV WITH TNE STATE <br /> CONTRACTORS LAW 19.27 RCW AND 29C>200 WAC. <br /> Signature ot OwncdContraetorlAulhor{zad Apom ��._.�;;�- ;,.;,�:"� ,, Data 04/12l2006 <br /> _...�f o�ri <br />