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, ^ERMIT APPLICAT( �N <br /> �C�� CITY OF EVER@TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820 i, 425-257-8810 <br /> i t zzos <br /> SITE ADDRESS PARCE L TAX 1.D.* P@RMITA� <br /> 5119 VIEW DR EVERETT,WA 98203 2905320030190n .��� _ <br /> j;_�7/ _, ;� <br /> LEGAL LO NO. BLOCK TRACT <br /> OWNER ADDRESS PNONE <br /> RHOADFS,71M 5119 VIEW DR <br /> � EVFRETT,WA 98203 (4�5)258•2563 <br /> TENANT NA14AE CONTAGT NAME pkONE <br /> PAMGLA HII.L a25 R14.3124 v I?3 <br /> CONTRACTOR ADDRESS CONTR.LICENSF#t <br /> FAS?WATER HEATER COMPANY 12601 132ND AVENE fASTWHC052DF <br /> (425)814•3124 KIRKLAND, WA 9803a 02�I6Q007 <br /> PROP05ED USE OF DUILDING �+��tl�^a M�chanlco Addltlon MEnT SouRCE � <br /> PERMIT Combloallon P�umnlnp WORK �y�eqqe� �I�adlc I <br /> TYPE o�moli��on slpn T'PE N�, �s <br /> � • aly dnt <br /> CONTRACT PRICE OF WORK 5449.00 CITY OF EVERE7T LOCAL 3ALES TAX CODEIS 3105 <br /> WdRK pE9CRIPTION Rcmove/R�pince Gu Warcr I�leatcr <br /> PL MBINO MECHANICAL <br /> OF FIXTUR[ -M OF 7(TURE OR ITEM <br /> _ _ WATER CLOSET AIC•AlHANDI.ING UNITS <br /> ____ BATHTUB ` FORCE�AIR SYSTEMS <br /> ______ LAVATORY(YVASH BASIN) � � MEAT PUMP <br /> ___ SHOWER � UNIT HEATERS <br /> ______ KITCHEN SINK R DISP06AL � � CIOTHEB DRYER <br /> __ _ D13HWA3MER � RANGE Fi00D <br /> ___ LAUNDRV TRAY WATER MEATER <br /> _ _ CLOTHES WASHER ^ METAL FIREPLACEISTCVE <br /> _ URINAL � FIREPLACE INSERT <br /> _ ORINKINO FOUN7AIN � GAS FIREPLACE <br /> FLOOR DRA!N � GAS RANGE <br /> ___ BACKFLOW pREVENTER � ^ GAS PIPING <br /> _ ___ SINK (SERVICEIBARJMOPIETC,) EXHAUST FAN <br /> � OTHFR_ '--- <br /> --- _ OTHER_� <br /> -------��'-- <br /> --- —�_____..�.------ <br /> 'i -- -- —'— — - <br /> I MERE�YCERTIFY THAT I NAVE READ AND EXAMINED THIS APLICA710N AND KN��W TME SAME TG BE TRUE AND CORRECi.ALL + <br /> PROV�SqNSOF I,qWSAND ORDiNANCCS GOVERNIN6 THIS?VPE OF WORK WILL BE COMPLIEO WIHT WNETHER SAECIFIEO MEREI <br /> OR NOT.TME t>HANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTMORITti TO VIOL.�7E OR CANCFI THE PROVISIJN OF Ah�v <br /> OTMER STATE�V2 LOCAI lAW REGUTATING CONSTRUCT�ON OR iH�PERfORMnNCE OF CONS�'RUCTION.TMAT 1 AMAUfnORIZED <br /> BY i11E OWNER Cf THIS P.20PERN TO PERFORM THE WORK FOR WMICHAPpLiOA71041S!.1AOE AND 1 COMPLY WITH TNE STA7E <br /> CON7RACTORS LAW 18.27 RCW ANO 296.200 WAC. <br /> 51Bn�lura of Ownef/ControctorlAulhorized Apeni �� ���8 ��n2/2005 <br /> f: �A�.�� �� �: �' . <br /> u�.ai <br />