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<br /> From: 10/�7J2008 12:00 q867 P. 002/002 t� �
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<br />���� ` Q PEF�MIT' APPLeCATION 418445
<br />; ��;� .. ����� CITY QF EVERETT PERMIT SERVICES
<br />< ,. 3200 CEDAR STREET, EVERETT, WA a8201, 425-257-8810 �
<br /> '�"� 425-257-6857 FAX ` �;
<br />�'^—_=- SITE ADDRESS PARCEL TAX I.D.# PERMIT# ``!'
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<br /> w r�� _.. G 17 40 PL�EVERETT, WA 98201 00801900004100 /�/�I U(� I '1 ` �) n_ �iAf
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<br /> ��� LEGAL LOT NO. —(BLOCK ITRACT �
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<br /> �,y � OWNER ADD.tES3 PHQNE ,x�•
<br /> �'�;�'-a' SLAIIROOK,SHELLEY G1740PL (425)330-5167 � '
<br />� ,� ,< • EVERETT,WA 98201 �
<br /> ..,„_ " TENANT NAME CONTACT NAME PHONE ��;.'
<br />'"�",,.�,,�r' Carol Randall 800-454-8955 x 133 '��
<br /> " - CONTRACTOR ADDRESS CONTR.LICENSE# �'��r
<br /> a � ��' PAS'1'WA7'ERHEAI'ERCOMPANY 12601132NDAV8NE FASTW\VH948IIC .��-
<br /> �� ,s� � �� KJKKLAND, WA 95034 Ol/04/2010 �+�11�
<br />. � : 800-454-8955 �.1`
<br />� r �', ' PROPOSED USE OF BUILL7ING Bulldtnp Machm�ca WORK �d���O" HEAT SOUR�E ���
<br />.�.��_,� �� PERMIT Combinntlon Piumhing Altenllon Elactdc _
<br />"�'.�;-v-. ..�. TYPE DomollUan Styn TYPE New ac
<br />".;q..�."�� ���� r Re atrlMeint her
<br /> .�` CONTRACT PRICE OF WORK 5449.00 CITY OF EVERETT LOCAL SALBS TAX COOEIS 3105
<br /> WORK DESCRIPTION Removc/Replace Cos Water Heater
<br /> 4:. , PLUMBING MECHANICAL
<br /> N . TYPE OF IXTU E OR ITEM O TYPE OF FIXTURE OR ITEM
<br />�� f WATER CLOSET A(C•AIHANDUNG UNITS �.,��
<br /> Y ___ BATHTUB FORCED AIR SYSTEMS ' �
<br /> .� - LAb'ATORY (Itiia6H BASIN) , HEAT PUMP �� ,��
<br />°""� ___ SHDWER UNIT HEATERS Ji„
<br />',S�m�%�='�' ,_ KITCHEN SINK & OISP03AL CLOTHES DRYER �:�'
<br /> y,�-? - ____ �I:�HWASHER RANGE HOOD �j;��
<br /> ��'�` _,�_ LAUNORY TRAY 1 WATER HEATER `/,
<br /> __ CLOTHES WASHER METAL FIREPLACEISTOVE ;�5'
<br /> URITlAL �^ PIREPLACE INSERT � ;�
<br /> �., ' ,_,__ DRINKING ��fJUNTAIN GAS FIREPLACE p
<br />��� „�`! FLOOR DRAiN GAS RANGE �i�
<br /> _� BACKFLOW PREVENTER GAS PIPING
<br /> '-` __ SINK (SERVICE/BAR/MOP/ETC.) EXHAUST FAN _ �!�'
<br />�-^ "'" � "' --- OTHER_ OTHERA--� .,`
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<br /> ��Fyy�"�6-�, t HEREAV CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL
<br />' �a°� � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OP WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI
<br />���� OR NOL TNE GRANTING OF A PERMIT DOES NC:T PRESUME TO GIVE AUTHORITY TO VIOW7E OR CANC9L THE PROVISION OF ANY
<br />� a�:,. OTHER STATE OR LOCAL lAW REGULA�'ING CONSTRUC710N ORTHE PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZEO
<br />�.w� ��, . BY THE OWNER OF THIS PROPERTY TO PERFORM 111E WORK FOR WHICH APPUCATION IS NWOE AND I COMPLY WI7H THE STATE
<br />. ; _ CONTRACTORS LAW 18.27 RCW ANO 2F36200 WqC.
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<br />_.,,,,V�_ Slgnatura of OwnorlContrector/Authorizod Agent �, ,���,.�,,,,�pP Date �0l07/2008
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