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Sent By: HP LaserJet 3100; <br />4258249516; Jun•12-06 3:4BP1.1; Page 2/3 <br />,��. PEkMIT APPLICATION <br />� CITY �F EVERETT PERMIT SERVICES <br />`,� 3200 CEDAR STREET, EVERETT, VVA 98201, 425-257-8810 ��,i_u� <br />SITE ADDRESS PARCBL 7AX I.D.# PER�AITit <br />171i \1CDOUGALI.AVG. EV�RE'l"I�, V�A 93201 004388353(IOi00 ��(pbiv'� 7( <br />OWNER <br />nITTHhLAtiEK, MICIILLI.L' <br />CONTRACTOR <br />I�p$l' N'ATFR ILF.ATGk COMPANI' <br />PH9lL_ �a'—S�s�s-l�za <br />PROPOSED USE OF BUILDIN <br />ADDRESS <br />177$ MCl�OU(iALL AVt <br />• EVARfI"I', �VA 95301 <br />CONTACT NAME <br />PAMELA tllLl. <br />i2r�oi i��ut��ve�e <br />KIKKLAND. \YA 9303•1 <br />pamdilion <br />ACT PRIC� OF WORK F4d9.00 <br />DFSCR�PTION he�����,��Nepl;ue 4at W2Ief Hcaler <br />� <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SNOWER <br />KITCHEN SINK 3 UISPDSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CL07HE5 WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKROW PREVENTER <br />SINK jSERVICEIBARlMOPIE7C,) <br />OTHER_��_ .� <br />PWmbing �WORK <br />t;,,,, TYPE <br />� <br />PHONE <br />(20G1?'S-I W9 <br />PHONE <br />4zs 811-31^�t s133 <br />CONTR.LICcNSE# <br />FAST\VWH9�ISRC <br />UI/U{�-005 <br />All�ratlon <br />Naw <br />LOCAL SALES 7AX CODEIS 31 <br />FORCED AIR SYSTEMS <br />HEAT 'U AtP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE 1100D <br />WATER HEATER <br />METAL FIRFPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTH E R_____________ _. <br />-i -- -- <br />1 M[REFiY CERTIFY THAT I NAVE READ AND EXAMINED THIS APIICATION A'�D KNOW THE SnME t0 BE 7RUE AND CORRFC7. ALL <br />PROVISIOMS OF LAWS A40 ORDINANCES GOVERNING THIS TYPE O� WO:tK \YILL BE GOh1DLIED WIHT \VHETHER SPECIFIED HERE <br />OR NOT. T11E GRANTING OF A PERh11T DOES NOT PRESUME TO GIVE AUTI ORITY TO VIOLATE DR CANCEI THE PROVISION OF ANY <br />OTMER STATE OR LOCAL lAW REGUTATING CONSTRUCTION OR THE PERPORMANCE OF CONSTRUCTION. THAT ( AM AUTMORIZEO <br />BY TME OWNER OF TMIS PROPERTY TO PERFORM THG WORK FOR WHICi i APPUCATION IS MADE AND I GOMPLY WI7H THE STRTE <br />CONTRACTORS LAW �8.27 RCW AND 296.200 WAC. <br />nature o( OwnerlControctorlAuthoriz9d Agen� <br />... ;.'-._ �. . Dats ���12/2006 <br />ui .:i <br />