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From: 11/3"�2UD6 13:55 q281 P.003/003 <br />,-��� PERMIT APPLICATION <br />(��i�� CITY OF EVERETT PERMIT SERVICES <br />F 3200 CEDAR STREET, EVERETi', WA 98201, 425-257-8810 <br />113006 <br />SITE ADDRESS PARCEL TAX I.D.# PERMITtt <br />S 1 1 RUCKER A V H, C• V ERHTT, NA 98201 0045881 G900500 <br />ti� ��� � �� - ���- <br />LEGAL LOT NO. BLOCK �TRACT <br />D <br />OWNER AODRESS PHONE <br />YATES, BA(LI3AltA 811 RUCKL•R AVE (q?S)259-2064 <br />• L•VERETT, WA 98201 <br />TENANT NAME CONTACT NANiE PHONE <br />PAMELA HILI. 425 814-3124 x133 <br />CONTRACTOR ADDRESS CONTR.LICENSE# <br />�AST NATER HGATER COMPANY 13601 132ND AVE NE PASTWIV}i9488C <br />�425�8�4 3�Za KIIiKLAND, 1VA 98034 01/03/2008 <br />PROPOSED USE OF BUILDING BUIldinp M��hanlea WORK Additlo� HEAT SOURCE <br />PERMIT Combinatlon Plumbinp Allantlon Electric <br />7�'pE Damolilion Slpn TYPE New Gas <br />� Re sirlMalnt Olher <br />CONTRAC7 PRICE OF WORK S349.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION Rcmovt/Replacc Electric \Vatcr He�ter <br />Q�UMBING MECHANICAL <br />NO. E OF FI%TURE OR I EM N PE OF FI%TU E OR ITEM <br />�,_ . WATER CLOSET ____ A/GA/HANDLING UNITS <br />___ BATHTUB ,____ FORCED AIR SYSTEMS <br />____ LAVATORY (WASH BASIN) __,__ HEAT PUMP <br />____ SHOWER __ UNIT HEATERS <br />„__ KITCHEN SINK 8 DISPOSAL ___ CLOTHES DRYER <br />__ DISHWASHER _ RANGE HOOD <br />__� LAUNORY TRAY �_� _ WA7ER HEATER <br />A_ CLOTHES WASHER __ METAL FIREPLACElSTOVE <br />__ URINAL _ FIREPLACE INSERT <br />__ ORfNKiNG FOUNTAIN _� OAS FIREPLACE <br />FLOOR DRAIN _ GAS RANGE <br />__ BACKFLOW PREVENTER GAS PIPING <br />_, SINK (SERVICE/BAR/MOPIETC.) ___ EXHAUST FAN <br />_____ OTHER .__ ___ OTHER___ __�_______.^_ <br />l HEREBY CERT7FY THAT I HAVE READ AND EWiMINED TNIS APLICATION AND KNOW TtiE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TfiIS TYPE OF WORK WILI BE COMPLIED WIHT WHETHER SPECIFIEO HEREI <br />OR NOT. THE GRANTING OF n PERMIT OOES NOT PRESUME TO ONE AUTHORIiY TO VIOLP.TE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION UR THE PERFORMANCE OF CONSTRUCTION. THATI AM AUTHORIZED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WH�CH APPLICATION IS MADE AND 1 COMPLY WITM TNE STATE <br />CONTRACTORS V�W 18.27 RCW ANO 296.20D WAC. <br />Slgnatura of OwneNContraerorlAuthorizod Jlgeni �-:; �,T �G/.-� � Date � ��30/2006 <br />ui om <br />