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Sent By: HP LaserJet 3100; 4258249516; Mar-37 •05 11 :10AM� Page 4 <br /> PEKMIT APPLICATION <br /> �i��� CfTY OF EVERETT PERMIT SERVICES <br /> `� 3200 CEDAR STREET, EVERETT, �NA 98201, 425-257-8810 <br /> 0331UG <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITt! <br /> M130: I DR SL,EVF.RE'fT,WA 98207 007849UWOli 00 �7�7 � n • � <br /> ��� ' � '" Ji <br /> LEaAL LOTNO. BLOCK ITRACT <br /> OWNER ADGRESS PHONE <br /> 6302 t uR sr: <br /> CURNELL, wTSTC1N W.RI;TH , CVERF,TT,WA 98203 (425)513-5607 <br /> TENAI�T NAME CONTACT NAME PHONE <br /> PAML'1.,1 HILL 425 Rld-31ZA x11C <br /> CONTRACTOR AODRESS CONTR.LICENSEA� <br /> FAST WA'fGR RRA'fGR C0�IPANY 12601 132NU AVF.NE FA3'1'll'WHa4%BC <br /> (4.5)BIS-3124 <br /> K1W:T.AT:U,WA 98034 01/U3ROOR <br /> PROPOSE� USE OF 6UILDING ewimno MKn•ni� W�RK Addidon H T souRCE <br /> PERMIT Combin�llon ��umDln NNr�tla+ le�lrlc <br /> rrre o«nanuo� a�Qo rraF n.w ,. <br /> � R. .ona,m� .. <br /> GONTRACT PRIC! Gi L�Cn!K E449.00 CITY OF EVERETT LOCAL SALES TAIf CODEIS 3105 <br /> WORK OESCRIPTION RemnrdKeplacc Gas Water Heutcr ` <br /> PLUMBING � UECHANICAL <br /> E OF FI%TURE O ITEM r F TUR F IT <br /> __ WATER CLOSET _____ A1C-AlNANDLING UNITS <br /> _,_ GATNTUB ______ FORCED AIR SYSTEMS <br /> ___ LAVnTORY (WASN BASIN) �_ HEAT PUMP <br /> ___ SNOWER _�__ UNIT NEATlRS <br /> __ KITCNEN SINK 4 O�SPOSAL ___ CLOTFiE3 DRYER <br /> OISHWASHER ._ RANGE MOOD <br /> , LAUNDRY TRAY _� WATER HEATER <br /> _ CLOTM89 WASHER ,_� METAL FIREPLACEfSTOVE <br /> URINAL _�_ FIREPLACE INSERT <br /> ^ DRINKING fOUNTAIN _r_ OAS FIREPLACE <br /> FLoOR DRAIN (iA5 RANGE <br /> eACKFLOW PREVENTER __ OAS PIPtNG <br /> ____ 91NK (SERVICEIBARIMOPlETC.) ___ EXHAUST fAN <br /> OTHER �-- --- OTHEF----�_..------_--�- <br /> i HERGBY CLRTIFY THAT I HAVE READ AND E%AMINED THtS APLICATION A�D KNOW TME SAME TO BE TRUE ANO CORRECT.AlL <br /> PROVISiONS OF�AWS�No ORDINANCeS GOVERNIN6 THIS TYPE OF WOF.K WILL BE COMPLIED W IHT WMETHER SPEpFIEO MEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES N07 PRESUME TO�NE AUTH�RITY TO VtOLATE OR CANCEL THE PROVISION OF ANY <br /> OTMER STATE OR LOCAL IAW REGUUTING CONSTRUCTION ORTME PERFORMANCE OF CONSTRUCTON.T�AT IAMAUTNORIZEO <br /> BY THE OWNER OF THIS PROPERTY?0 PERFORM TME WORK fOR WMICN APPIIGATION IS hUDE AND�COMPLY WITH TnE STAtE <br /> CONTRACTORSLAW 18.27 RCW AND 296.200 WAC, <br /> SfpnatuN Ot DwnodContnctor/Authorized ApEN ��._�_:�-�, ,,,�;i'�.�� • DaM p3/31RU0C <br /> u�M� <br />