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From: 11/�'/2006 07:06 N042 P.003/003 <br /> PERMIT APPLICATION <br /> ��i�� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> I1I706 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 2107 RUCKEIi AVE, EV81LL•Ti, WA 95201 00437043300400 � //_ � <br /> LEGAL LOT NO. QLOCK ITRACT <br /> EK <br /> OWNER ADDRESS PHONE <br /> W INDL•,ROSS 2107 RUCKLR AVE �q25)252-9092 <br /> • EVERETT,WA 98201 <br /> TENANTNAME CONTACTNAME PHONE <br /> PAML•LA FllLL 425 814-3124 �133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> PAST 14A'fER HL•ATER COMPANY 1?.G01 132ND AVE NE FASTVVNH9488C <br /> KIItKLAND,\VA 98034 Ol/03R008 <br /> (425)814-3124 <br /> PROPOSED USE�F BUILDING eu��d�np M�chenlea WURK Addlllan HEAT SOURCE <br /> P6RMIT Com6lmtlon Plumbing AllweUon ElecMc <br /> TypE Demolllion Slpn TYPE Na,�, Gas <br /> � R� elrlMalnt Other <br /> CONTRACT PRICE OF WORK S3v9.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK OESCRIPTION �Lentove/Reploce Llectric Naler l�icater <br /> PLUMBING MECNANICAL <br /> N . OF FI TURE OR ITE NO TYPE OF F 1CTURE R ITEM <br /> ___ WATER CLOSET ______ A/C•A/HANDLING UNITS <br /> ___ BATHTUB _____ PORCED AIR SYSTEMS <br /> ____ LAVATORY (�`1ASH BASIN) HEAT PUMP <br /> ____ SHOWER __ UNIT HEATERS <br /> ___ KITCHEN SINK & DISPOSAL _ CI.OTHES ORYER <br /> DISHWASHER � _ RANGE HOOD <br /> __ LAUMORYTRAY _!__ WATER MEA7ER <br /> __ CLOTHES WASHER ,_� METAL FIREPLACEfSTOVE <br /> _� URINAL ___ FIREPLACE INSERT <br /> � DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> �_ BACKFLOW PREVENTER ___ GAS PIPING <br /> ___ SINK (SERVICEIBARlMOPlETC.) ___ EXHAUST FAN <br /> --- OTHER----- —�_ OTHER---_-----------_-- <br /> I HEREBY CERTIFY THAT I HA`!E READ AND E%AMINED THIS APLICAT70N AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED WIHT WHETHER SPEGFIED HEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGUI.ATING CONSTRUCTION OR TIiE PERFORMANCE OF CONSTRUCTION.THATI AM AUTHORiZED <br /> BY THE OWNER OF THIS PROPERIY TO PERFORM THE WORK FOR WHICH APPLICATION IS MqDE AND 1 COMPLY WITM i ME STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.20�WAC. <br /> Signature of OwnurlContreator/Authorized Ageni ��� ��-_�.�� Date ������z006 <br /> ui.m <br />