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From: 0"12/2010 14:47 p291 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 />SITE ADDRESS aertce� Tev � n�r �� <br />4322 5 3 AVG, L'V�RETT, \VA 98203 <br />owNe� <br />LUONG, I�UNG <br />00500400701100 <br />ADDRESS <br />d322 S 3 AVG <br />BVERGTT, WA 98203 <br />Carol Randall <br />CONTRACTOR ADDRESS <br />FAS7' WATBIZ 1'.EAT�R COMYANY 12601 132ND AV8 NG <br />425-636-7054 ��ZKLnND, WA 98034 <br />PROPOSED USE OF BUILDING eui�ainp M <br />PERMIT �- Comblmllon PI <br />Residential TypE O�mouaon gi <br />S349.00 <br />DESCRIPTION <br />Removc/Rep6icc Glcclric Watcr Hcalcr <br />BATHTUB <br />LAVATORY (WASH BASINy <br />SHOWER <br />KITCHEN SINK 6 DISPOSAL <br />DISHWASHER <br />WUNDRY TRAY <br />CLOTHES WASHER <br />URINAL . <br />ORINKING FOUNTAIN <br />FIOOR DRAIN <br />BACKFLOW PREVENTER <br />91NK (SERVICF�BAR/MOP/ETC.) <br />OTHER <br />TYPE <br />OF <br />PHONE <br />474892 <br />�azs>zss-a� i v <br />PHONE <br />425-�96-7054 <br />CONTR.LiCENSE# <br />FAST ;VN'H948[3C <br />01/042012 <br />TAX <br />SOURCE <br />_ - . v a�m�u <br />___ FORCED AIR SYSTEhiS <br />_ HEAT PUMP <br />__ UNIT HEATERS <br />_ CLOTHES URYER <br />_ RANG[ HC9D <br />��__ WATER HEATER <br />__ METAL FIREPLACFJSTOVE <br />��_ FIREPLACE INSERT <br />_ GAS fIREPLACc <br />GAS RAN6E <br />6A3 PIPIN6 <br />�� EXHAUSTfAN <br />_ OTHER_ _`_�,_ <br />I HEREBY CERTIFY TIiNT I HAVE REAO AND E.`IAMINED THIS APLICq7�ON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIO�S OF lqWS ANO OR�INANCES GOVERNING THIS TYPE OF N'ORK WILI BE COMPLIEO WIHT WMETHER SPECIFIED HERE <br />OR NOT. THE GRANTING UF q PE'RMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHERSTATE OR LOCAL LAW RtCULATING CONSTRUCTION OR THE PERfORM4NCE OF CONSTRUCTION. THAT IAM AUTHORI2ED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WQRK FOR WHICHAPPLICATION IS MADE AND t COMPIY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC, <br />of <br />Agont <br />D�ts Ol/122010 <br />UI_MI <br />