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From: 07/�9I2011 11:07 r865 P.002/003 <br />�.-� PERMIT APPLICATION <br />(,w��� CITY OF EVERETT PERMIT SERVICES <br />F 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />4 425-257-8857 FAX <br />SITE ADDRESS <br />501'_ S Z:\VL', GVLRE'1'T, NA 98203 <br />OWNER <br />CONNOR, LOIS <br />Ni1NT NAME <br />4RCEL TAX I.D <br />OUSOU3UUti0U3U0 <br />ADDRESS <br />5orz s z.�vs <br />� L'VCItL'TI', \VA JS203 <br />CONTACT NE <br />CONTRACTOR ADDRESS ' <br />F.\S'1' N'Al'liR HIiA'fGR COMPANY 1?G01 132NU AVG NH <br />};lltRLAND, WA 98034 <br />425�36-70$ <br />PROPOSED USE OF BUILDING euud�no r+�achan�ca WURI <br />PERMIT Com6tnatlon ' Plumbing <br />ReSiden�ial 7YpE Domolilian Slpn TYPE <br />PRICE <br />WORK �ESCRIPTION �temovc/licplace lilectric N�atcr 4lcatcr <br />LAVATORY (WASH �ASIN) <br />SHOWER <br />KITCHEN SINK $ DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEJBAR/MOPfETC.) <br />OTHER_ __ <br />�� <br />� <br />�� <br />549063 <br />PHONE <br />�azs>zs��-o�a9 <br />CONTR.LICENSE# <br />i'ASTWN'11943UC <br />01/U4/'_012 <br />SOURCE <br />TAX CO�EIS 3105 <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREP[ACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTH ER------------------ <br />HEREBY C[RTIFY THAT I HAVE READ AND EXAMINEO THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORN[CT. ALL <br />'ROVISIONS OF LAWS ANU ORDINANCES GOV[RNING THiS TVPE OF WORK WILL BE COMPLIED WIIiT WHE7HER SPECIFIED HERE <br />)R N07. THE GRANIING OFl� PERMIT DOES NOT PRESUh1E TO GIVE AU7HORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />)THER STl�TE OR LOCAL IJ�W RE(iUU1TING CONSTRUCTION OR TNE PERFORMANCE OF CONSTRUCTION. THAT I AM AU7HORIZED <br />If TI1E OWNER OF THIS PROPERTY TO PERFORM TNE 1YORK FOR WHICH APPLICATION IS MNOE AND 1 COMPLY WITH TME STATE <br />:ONTRACTORS LAW 18.27 RCW ANU 296200 WAC. <br />IgnaWro ot OwnodContracmr/Authorizod Agont <br />Date p7l1S/ZOII <br />wpn <br />