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From: 11I0� /2010 10:07 �814 P.002/002 <br /> ( <br /> PERMIT APPLICATION 511744 <br /> �+i� CITY OF EVERETT PERMIT SERVICES <br /> T 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX � � <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT� <br /> ?2 5 SHORI:AVG, EVERE7'1', WA 98203 00571700900700 <br /> '. i��\IU - �U <br /> IEGAL LOT NO. BLOCK TRACT <br /> OWNER AODRESS PHONE <br /> � GI1313S,GL•OPfRL1' ���StiHORtiAVI? (206)715-4332 <br /> • EV[RC•TT, WA 98203 <br /> TENANT NAME CnurprT u w..� I /y� I �y 1� PHONE <br /> ��, 6 61 �' \ 425-636-7C�54 <br /> CONTRACTOR ADDRESS CONTR.LiCENSEA� <br /> PAST\VATGRIIL'ATI:RCOMPANY 12G01 132ND:1VBNG fASTWWH94Rt3C <br /> RIRKI.AND,\VA 9R034 01/04/2012 <br /> 425-636-7054 <br /> PROPOSED USE OF BUILDING sulldinp M.on.me. Additbn H T 90URCE <br /> PERMIT Combinauon vlumbinp W�RK Mtaanoo NcMc <br /> Residential TypE D�molilion Slpn T�'PE M�w as <br /> R� NrlMtlnl ar <br /> CONTRACT PRICE OF WORK CITY OF EVERETT�OCAL SALES TA7(CODEIS 7705 <br /> WORK DESCRIPTION RcmovclReplace Gos Watcr Heatcr <br /> PLUMBING MECHANICAl� <br /> N . F U ITE O FI TUR R ITEM <br /> __ WATER C�OSET _,__ AIC•A/HANDLINti UNITS <br /> __ BATHTUB »__ FORCED AIR SYSTEMS <br /> _! LAVATORY(WASH BASIN) ____ HEAT PUAIP <br /> _ SHOWER ___ UNIT HEATERS <br /> __._ KITCHEN SINK d OISPOSAL ___ CLOTHES ORVER <br /> __ DISHWASHER _ RANGE HOOD <br /> ___ LAUNDRY TRAV � � _ WATER HEATER <br /> __ CLOTNES WASHER __ METAL FIREPl110E/STOVE <br /> T URINAL _!__ FIREPUICE INSERT <br /> DRINKING FOUNTAIN OA3 FIREPLACE <br /> FLOOR DRAIN GAS RAN6E <br /> BACKFLOW PREVENTER GAS PIPING <br /> __ SINK (SERVICFJBARlMOPlETC.) �,_ EXHAU3T FAH <br /> ^ OTHER_^_ _ OTHER________�__ <br /> 1 HEREBY CER7IFY T11AT I HAVE READ AND EXAMINED THIS�PLICATiON AND KNOW TNE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIOMS OF lAWS AN�ORUINANCES GOVERNING Tf11S TVPE OF WORK WILL BE COMPLIEU WIHT WHETHER SPECIFIED MEREI <br /> OR NOT.THE GMNTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY <br /> OTHEF2 STATE OP 'OCAL V�W REGULATING CONSTRUCTION pR TME PERFORMANCE OF CONSTRUCTION.TMAT I AM AUTHORIZED <br /> 6Y THE OWNER O� 1115 PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE ANO 1 COMPLY WITM THE STATE <br /> CONTRACTORS LA 16.27 RCW AND 296.200 WAC. <br /> Sipr.e!_:e uf Ow�edContractor/Authorixad Apanl Date <br /> 1029/2010 <br /> u��ni <br />