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fron: 12/OB/20U6 10:19 p575 P.002/003 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />._ ' 3200 CEDAR STREET, EVERETT, WA 9B201, 425-257-8810 <br />SITE ADDRESS <br />5918 3 DR N, GVLRGTT, NA 98203 <br />OWNER <br />DIXON,IAMES <br />NAME <br />4RCE L TAX I.I <br />0081G400001G00 <br />ADDRESS <br />59183DR�V <br />GVL•RC•TT, WA 98203 <br />�CONTACT NE <br />� PAMHLA H1L1 <br />CONTRACTOR ADDRESS <br />PAST lVA'iER HL•ATER COMi'ANY 12G01 132ND AVE NL <br />PHONE (az5)814-3124 KIItKLAND, WA 98U34 <br />PROPOSED USE OF BUILDING Bulldinp M�chanica <br />PERMIT Combination Plumbinp WORK <br />TYPE D�molition g�g� TYpE <br />rnlr <br />CONTRACT PRICE OF WORK ,�4J9.00 CITY OF EVERET <br />WORK DESCRIPTION <br />RcmovcJAcpl¢ce Gas 1Vatcr Hcatcr <br />WATER <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISNWASHER <br />LAUNORY TRAY <br />CLOTHE3 WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPIETC,) <br />OTHER_ <br />� <br />120506 <br />PERMIT# <br />cU � Z _�� . <br />PHONE <br />(425)34R•9425 <br />PHONE <br />A25 R14-3124 si;3 <br />CONTR.LICENSE# <br />FAST�1'R'H948�C <br />01/U3/2003 <br />� H T SOURCE <br />�� Electric <br />aa <br />Nalnt ther <br />LES TAX CODEIS 3105 <br />FORCED A�R SYS7EMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGENOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />OAS FIREPLACE <br />GAS F2ANGE <br />GAS PIPINO <br />EXHAUST FAN <br />O 7H E R-------------------- <br />NeREBY C[RTIFY THAT I HAVE READ AND EW+MINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL <br />'ROVISIONS OF Ll�WS ANO ORUINANCES GpVERNING TfiIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED N[RE <br />)R NOT. THE GRAN7ING OF A PERMI7 DOES NOT PRESUME TO GN[ AUTIIURIN TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />)THER STATE OR LOCAL LJ�W REGUTATING CONSTRUCTION OR TNE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED <br />iY THE OIVNER OF THIS PROPERIY TO PERFORM THE WORK FOR WNICH APPUCATION IS MADE AND I COMPLY WITN THE STATE <br />:ONTRACTORS LAW 18.27 RC1A' ANO 298.200 WAC. <br />of OwnedConlrector/Authorized AgeN ��,.�, _ ��:-� — , Date <br />-- - . — r . .r�:�� 12/08/2006 <br />