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T�pd-11-�'Ull ?IJ:IJ� From:a�SS149516 <br />Faye:3'b <br />- PERMIT APPLICATION <br />��i�CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-881 D <br />425-257-8857 FAX <br />10935 3 DR SE, EVERtTT, WA 98z08 <br />OWNER <br />P[NA,pEVGRLY <br />NAME <br />PARCEL TAX I.1 <br />00761G00002000 <br />ADDRESS <br />�o9s5 s oxse <br />� FVERI3TT. WA 98208 <br />CONTRACTOR ADDRESS � <br />I�nST 1VrciL'R HL'ATGR COMYANY 12601 l3�ND AVc- rrE <br />KIWCLANU,wn 9So3a <br />P�Q 425-636-70g� <br />PROPOSED USE OF BUILDING eu��e��o ba�n�n�ca <br />PERMIT Combinalton �lumbinp WORI <br />Residential 7YpE oamonuon sipn N�'E <br />OF <br />� <br />WORK DESCRIPTION Remo��c/Itcplaee filectric Water Hcntcr <br />BATHTUB <br />LAVATORY (WASM BASIN) <br />SHOWER <br />KITCHFN SINK 6 DISPOSAL <br />DISHWASNER <br />IAUNORY TRAY <br />CLOTNES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />eACKFLOW PREVENTER <br />SINK (SERVICEfBAR/MOPJETC.) <br />OTHER <br />C]� <br />1 <br />CN14848 <br />I il. <br />PHONE <br />(d?5)433-2723 <br />PHONE <br />425-636-i 0� � <br />CONTR.LICEN: <br />FASTIV�VH948F�C <br />O t /04R012 <br />Add�Gon H�T SOUR <br />Albratlon �JElecldc <br />N�w as <br />�lR�palrlMalN er <br />LOCAL SALES TA7( CODEIS 3� <br />AIC-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />1{EAT PUMP <br />UNIT MEATERS <br />CLOTHES DRYER <br />RANGE NOOD <br />WATER HFI�TER <br />METAI FIREPWCE/STOVE <br />FIREPIACE INSERT <br />GAS FlREPLACE <br />GAS RAN6E <br />6A5 PIPING <br />�(NAUST FAN <br />OTHER_,A___,�� <br />-� i � <br />HEREBY CLRTIFY 7W1T I MAVE RFAD /1ND C-%AMINED THIS APLIG1T10N AN� KNOW TH[ SAMB TO B[ TRUE AND CORR[CL ALL <br />'ROVISIONS OF LAWS ANO OH�INANCES GOVERNING TIiIS TYPE OF WORK WILL BE COMPL�ED WIIiT WtiE7HER SPECIFIED HERE <br />1R NOT. TNE GW+NTING OF A PEKMIT DOES NOT PR[SUME TO GNG AUTNORITY TO VIOLA7E OR Cl+NCEL THE PROVISION OF ANY <br />)THER STATE CZ �OCAL LAW REGt1LATING CONSTRUCTION pR THE PERFORAMNCE OF CONSTRUCTION. THAT I AMAUTHORIZED <br />IY THE OWNER OF TtiIS PROPERTY TO PERFORM T?1E WORK FOR WHICH APPLICATION IS MADE AN� I COMPIY WITH THE STATE <br />:ONTRACiORS LAW 78.27 RCW AND 29G200 WAC. <br />of OwnedContractodAulhorizod Aticpl <br />bato 06l10/2011 <br />U! MI <br />