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��� P4 RMIT APPLICATIti,sV <br /> � CITY OF EVERETT PERMIT SERVICES <br /> ._ 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> CK I 677 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 4dOd"fCRRACE DR tlW,f_VGR87'7', WA 98203 00G8?500501400 /J 1/ � � �; <br /> / (1��_, (i <br /> IEGAL LOT NO. BLOCK ITRACT <br /> DE <br /> OWNER ADDRESS PHONE <br /> RYAN,DAVID 4404 TI:RRACE DR�114 (425)257-3137 <br /> • GVERGTT, WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> PAMGLA HILL -025 SIJ-3124 �13? <br /> CONTRACTOR ADDRESS CONTR.LICEIJSE# <br /> PASI'N'ATGR H6ATGR COMPANY 12G01 132ND AVF:NH pASTWIIC052DF <br /> (d25)814-3124 KIRKLAND,WA 98034 02/IGl2005 <br /> Buildinp M�eh�ni�C� WORK Addfllon <br /> PROPOSED USE OF BUILDING HEA'i' SOURCE <br /> PERMIT Combin�Hon Plumbin Altara8on ENcMc <br /> nPE D�molitlon sio„ rvre N.W ,� <br /> r R� urANainl her <br /> CONTRACT PRICE OF WORK $349.00 CITY OF EVERETT LOCAL SALES TAl(CODEIS 7105 <br /> WORK DESCRIPTION Rcmove/Replace 8lectric Watcr I Ieatcr <br /> PLUMBING MECHANICAL <br /> NO. TY OF TU ITE O OF FIXTUR OR ITEM <br /> ______ WATER CLOSET ______ A/C-A/HANDLIN6 UNITS <br /> ____ BATHTUB ��__ FORCED AIR SYSTEMS <br /> ____ LAVATORY (YYASH BASINj ______ MEAT PUMP <br /> ___ SHOWER ___ UNIT HEATERS <br /> ___ KI7CHEN SINK 6 DISPOSAL _�_ CLOTHES DRYER <br /> _� DISHWASHER _ _ RANGE HOOD <br /> �__ LAUNDRY TRAY _�__ WATER HEATER <br /> ,_ CLOTHES WASHER ___ METAL FIREPLACElSTOVE <br /> _ URINAL ___ FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> __ FLOOR DRAIN ___ GAS RANGE <br /> _�_ BACKFLOW PREVENTER __ GAS PIPIN6 <br /> ___ SINK (SERVICE/BARIMOP/ETC.) ___ EXHAUST fAN <br /> �___ OTHER_ ___ OTHER_____,____`_________ <br /> I HEREBY CERTIFY THAT I MAVE READ AND EXAMINED THIS APLICATI9N AN�KNOW THE SAME TO BE TRUE AND CORRECT,ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETNER SPECIFIED MEREI <br /> OR N07.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTNER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR TME PERFORMANCE OF CONSTRUCTION.TMAT I AM AUTHORIZEO <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPIY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> Signature of OwnedContraetorlAuthorized Agem �,. - ��- ���'� j Date �0/28/2004 <br /> u�Mi <br />