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Sent 5y: H? LaserJet 3100; <br />425024951�j Apr-5-06 10:2GAl.1� Page 2/4 <br />,,--��✓�� PErIMIT APPLiCAT10N <br />CITY OF EVERETT PERMIT SERVICES <br />_, 3200 CEDAR STREET, FVER�TT, WA 98201, 425-257-8fi10 <br />uausoe <br />SITE ADDRESS PARCEL T/�: I.D,# PERMIT# <br />ruo:allxw,Evattr-.n,w:� 9xzo� ansieanoonr,ion 1�'l0(a0`{_CO'� <br />.7^l;I�� <br />,��UCRSON,RliSSELL <br />ADDRESS <br />G00� 4 DR R' <br />� GVCRETT, Wp 982U3 <br />CONTACT NA <br />r,�htel.n nll.� <br />CONTRACTOR ADDRESS � <br />I',45T \1'ATF.R HI?A'I LIL COMPANI' 12GOI l:i?ND AVE �L <br />(J"_'S)%14-;124 1�IItFLAND,1i'A 9803a <br />�� ' <br />PROPOSED USE OF BUILDING Oulldlnp Mec��an�c■ <br />PERMIT Combinetlon pi�mb�np WORK <br />TYPE �amolition S�pn T'PE <br />CON7RqCT PRICE OF WORK �qa9,00 <br />WORK OESCRIPTION Remo��eiKeplace Gas 1Vater Hcaiu <br />f�� <br />WATGR CLOSET <br />BATHTUB <br />LAVATORY (WASH QASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASH[R <br />LAt1NDRY TRAY <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPlETC.) <br />� <br />PHONE <br />(a?51265-032U <br />PHONE <br />�:s si�-;�i�a�i�� <br />CONTR.LICcNSEp <br />FA511�'�VH9JRIiC <br />01�03�20DS <br />SOURCE <br />■c <br />LOCAL <br />�105 <br />A/C-A/IiANDLIN� UNI75 <br />FORCE� AIR SYSTEMS <br />HEAT pUMP <br />UNIT HEATERS <br />CLOTNES DRYER <br />RANGEHOOD <br />WATER HEATEFi <br />METAL FIREPLACEISTOVE <br />FIREPIACE INSERT <br />OA9 FIREPLncE <br />GAS RANGE <br />(iA5 PIPINC3 <br />EXHAUST FAN <br />O TH E R-�------�------------ <br />I H[RE6Y CLRTIFY TFIAT I ItAVE READ ANO [Xl�MIN6p THIS APUCATION AN� KNOW THE SAME TO 6E TRUE hN0 CORREC7 All <br />PROVISIONS OF LAWS ANU ORUIMANCES GOV[RNING THIS TYPE OF WOR< WILL BE COMPUED NINT WHETNER SPL'CIFIED HERE <br />OR NOT. THE GRANTING OF A PGRMIi DOES NOT PRE5UAtE TU F�NE AUTNURITY TO VIOIAYF. OR CANCEI THE PROVISION OF ANY <br />OTHER STATE OR LOCAI. LAW REGULAI ING CONSTRUCTIUN UR THE PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTMORI2ED <br />�Y THE UWNER 0� i HIS PROPERTY TO PERFORM TNE WORK FOR WNICI I APPIICATION IS MAOE AND 1 COMPLY WITH TNE STATE <br />CONTfiACTORS LAW 7617 RCW ANU 29G2�0 V�'AC. <br />ignat�ro of OwnadContractor/Authorixed Agem �; ., , � ,�'�; � . . Dato 04%o5i2UUti <br />U� f'1 <br />