Laserfiche WebLink
�. ERMIT APPLICAti .dN <br /> ��y�� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-25T-8810 <br /> oiss,ai <br /> SITE ADORE$S PARCEL TAX I.D.# PERMIT# <br /> 2121 \VETMORL:IV6,EVFRETT,1'1A 98201 00439143601100 �1/� o3pC�- pZ�p <br /> LEGAL LOT NO. BLOCK TRACT <br /> OWNER ADDRESS PHONE <br /> S�IITH,TODD Z�Z� WETMOREAVE <br /> • EVERETT,WA 98201 (425)259•GOGS <br /> TENANT NAME CONTACT NAME PHONE <br /> PAMELA HiLL 425 814-3124 x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE� <br /> FAST WATGR HEATER CO��PPNY 12601 I3?ND AVE NE FASTWI�C052DP <br /> (425)b14-3124 KIRKLAND,WA 98034 02/16/2J05 <br /> PROPOSED C�SE OF BUILDING Bulldinp Mteh�nie� WORK Addltion H T SOURCE <br /> PERMIT Comhln�llon Plumbinp Ntentlon I�clrie <br /> n'pE Damolilion Sipn TMPE N�w as <br /> r R� airlMalnt ther <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 7705 <br /> WORK DESCRIPTION Rcmovc/Rcplacc Gas\Vatcr Hcatcr <br /> PLUMBING MECHANICAL <br /> NO. OF F TURE OR ITEM P OF XTUR R ITEM <br /> ______ WATER CLOSET _ _____ A/C-A/HANDLIN6 UNI75 <br /> _�_ BATHTUB ______ FORCED AIR SYSTEMS <br /> ____ LAVATORY �M1IASH BASIN) __�_ HEAT PUMP <br /> __� SHOWER ___ UNIT HEATERS <br /> ___ KITCHEN SINK 6 OISPOSAL _�__ CLOTF:C•S DRYER <br /> _� DISHWASHER _ _ RANGE Fi00D <br /> ___ LAUNDRY TRAY __1 _ WATER HEPTER <br /> __ CLOTHES WASHER ___ METAL FIREPLACE/STOYE <br /> __ URINAI. ____ FIREPLACE INSERT <br /> v DRINKING FOUNTAIN ___ OAS FIREPIACE <br /> __ FLOOR DRAIN ___ GAS RANGE <br /> ___ BACKFLOW PREVENTER ___ G.45 PIPIN6 <br /> __ SINK (SERVICEIBARIMOP/ETC�) ___ EXHAUST FAN <br /> ___ OTHER_ ___ OTHER_______�_______�_A <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES G�VERNING THIS TYPE OF WORK WIIL BE COMPLIED WIHT WHETHER SFECIF�ED HEREI <br /> OR NOT.THE GRAN7ING OF A PERMIT DOES NOT PR=SUME TO GNE AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING:.ONSTFUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT 1 AMAUTHORIZED <br /> BY THE OWNER Of THIS PROPERTY TO PERFORM THE VYORK FOR WHICH APPLICATION IS MADE ANO 1 COMPLY WITH TNE STATE <br /> CONTRACTORS LAW 70.27 RCW AND 296.200 WAC. <br /> Signature of OwnerlContractorlAuthorized Ageni �—l� �`.� D�ts 09/I I/2003 <br /> UI MI <br />