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Fron <br />07/1R/2011 11:07 n`865 P.003/003 <br />PERMIT /dPPLICATION 5'9ZQb <br />��i��CITY OF EVERET'T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br />6705 R'llJA\1' RD, rvekr•rr, \VA 98'_03 004358000UOS00 M I 1 r,� ��--I <br />• �i �v <br />OWNER <br />YAL�1ER, 13K1:N'1' <br />NAME <br />AODRESS <br />e�os ��'n.i.ow �tu <br />� I>VIiKI�I"I', N'A 98203 <br />CONTACT NAME <br />-�u�,� r�tsr_ <br />CONTRACTOR IADDRESS <br />PAS'1' WAl'GR HIsA7'81i COM1tI'ANY 12GD1 132ND AVB NE <br />I:IRIJ_AND, \VA 98034 <br />PROPOSED USE OF BUILDINGIpERh�17 <br />Residenlial npE <br />CONTRACT PRIGE OF WORK,9��� ��, "— <br />y' <br />WORK DESCRIPTION �tcmovc/Rcplacc Gas \V:ucr Hcarer <br />LAVATORY (WASH BASIN) <br />SNOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY 7RAY <br />CLOTHES WASHER <br />URINAI <br />ORINKING FOUNTAIN <br />FLOOR DRA1N <br />BACKFLOW PREVENTER <br />SINK (SERVICEJBAR/MOPfETC.) <br />Plumbing 1 WORK <br />Sipn �T�'PE <br />� <br />PHONE <br />(a25)231-589v <br />PHONE <br />nzs-sssao&4 <br />CONTR.LICENSE# <br />PAS'I'W\S'l l')4813C <br />01/0�/2012 <br />CODEIS 3105 <br />A1C-A/FIANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT fiEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER----------------- -- <br />HEREBY CERTIFY 1'I1AT I HAVE READ AND EXAMINED 7HIS APLICATION AND KNOW TH[ SAME TO BE TRUE AND CORRECT. ALL <br />'RrJVIS�ONS OF LAWS AND ORDINANCES GUV[RNING Th115 TYPE OF 1'lORK WILL BE COMPLIEU WIHT WMETHER SPECIFIED HLRE <br />)R NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE �UTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />)THER STATE OR LOCAL LAW REGULnTING CONSTRUCTION OR TNE PERFORMANCE OF CONSTRUC710N. THAT 1 AM AUTHORIZEO <br />IY T71[ OWNER OF Tl115 PROI'ERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITM THE STATE <br />:ONTRl�CTORS LA\4' 18.27 RCW AND 2U6.20D WAC. <br />ignaturu o( OwnodContractorlAuthorized Agant � � � � <br />oaia o�nxn.oii <br />U1 MI <br />