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From <br />�oiznizoos to:tz p331 P.002/002 <br />�- PERMIT APPLICATION <br />�CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />I OG04 4 DR SE, EVERGTI', WA 98208 <br />OWNER <br />TI IOMAS. LENARD <br />!iso <br />rnsr wn�•ca t u:nrea cuNrrnriv <br />I.D.# <br />00742900003200 <br />ADDRESS <br />10604 4 DR SG <br />• HVL'RGTT, WA 98205 <br />CONTACT NAME <br />Carol Randall <br />12GO1 132ND AVP_ NE <br />425-638-7054 ��-�h���VA 98034 <br />PROPOSED USE OF BUILDING euua��o M <br />PERMIT Combin■Ilon p <br />Residenlial �ypE D�moiltton g <br />CONTRACT PRICE OF WORK g349.00 ( <br />WORK DESCRIPTION �t�movc/Repince [Icctric N¢ter Hcater <br />___ BATHTUB <br />___ LAVATORY (WASH BASIN) <br />__, SNOWER <br />,___ KITCHEN SINK 6 DISPOSAL <br />__ DISHWASHER <br />_,__ LAUNDRV TRAY <br />_ CLOTHES WASHER <br />._ URINAL <br />URINKING FOUNTAIN <br />FLOOFi DRAIN <br />_ BACKFLOW PREVENTER <br />_____ SINK (SERVICE/BAR/MOPIETC.) <br />__ OTHER—_ <br />� <br />WORK <br />TYPE <br />463117 <br />PERMIT# <br />�� - 27 <br />PHONE <br />(425)745-G928 <br />PHONE <br />325-636-7054 <br />CONTR.LICENSE# <br />I'AS7lV W H94813C <br />o vonna i o <br />HEAT SOURCE <br />n qcldo <br />�s <br />elnt her <br />ES TAX CODEIS 3705 <br />AIC-AIHANDLING UNITS <br />FORCEU AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST PAN <br />OTHER <br />HER[OY CERTIFY THAT I HAVE RFAD AND EWN7INED THIS APLICA770N AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />'ROVISIONS OF LAVrS AN� ORDINANCES GOVERNING TNIS TYPE OF WORK WIIL BE COMPLIED WIHT WHETNER SPECIFIED HERE <br />)R N07. Tr1E GRANTING OF n PERMIT DOES NOT PRESUME TO GNE nUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />)TMER STATE OR LOCAL lAW REGUI.ATING CONSiRUCiION ORTME PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED <br />iY THE OWNER OF TIiIS PROPERTY TO PERFORM THE WORK FOR WHICHAPPLICATION IS MADE AND I COMPLY WITH THE STATE <br />:ONTRACTORS LAW 18.27 RCW AND 286.20D WAC. <br />Signaturo of OwnorlControctor/Authorizud Agent <br />Dats �0/20/20o9 <br />u� o�i <br />