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From: 05/�Q�2007 08:49 tt640 P.003/UO3 <br />PERMIT APPLICATION 367374 <br />�����CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S i REET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />SITE ADDKESS PARCEL TAX I.D.# PERMIT# <br />12305 21 AVE SE, EVERETT, WA 98208 00862900000900 j�' ��O �'_ <br />LEGAL LOT NO. BLOCK TRACT <br />OWNER ADDRESS PHONE <br />D]GUYEN, IiUNG 12305 2I AVE SE (425)379-OI2U <br />• EVLRLTI', \4A 98208 <br />TENANTNAME CUNTACTNAME . PHONE <br />Pamela Hill 800-454-8955 x 133 <br />CONTRACTOR ADDRESS CONTht.UCENSE# <br />FAS'CWATEItH6AT6BCOMPANY 12G01 132NDAVENE PASTWWH948IIC <br />(425)814-3124 KIRKLAND, WA 98034 Ol/03/2008 <br />PROPOSED USE OF BUILDING eW�ump r,��ehaNca WORK Add�tlon HEAT SOURCE <br />PERMIT Com6lnallon Plumbine Nt�ntion El��trie <br />7ypE Demolllion Slgn TYPE Naw as <br />S rl kI r Rs airlMalnt ther <br />CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION Rcmove/Repince Gas Wa[er Heater <br />PLUMBING M�j�iANICAI. <br />NO. OF URE OR ITEM O TYPE OF FIXTURE OR ITEM <br />�_ WATER CLOSET ______ A/C-A/HANDLINCi �NITS <br />�_ BATHTUB _,_____ FORCED AIR SYSTEMS <br />_� LAVATORY (WASH BASIN) �___ HEAT PUMP <br />__� SHOWER _�_ UNIT HEATERS <br />,__ KITCHEN SINK 8 UISPOSAL ____ CLOTHES ORYER <br />__ OISHWASHER _ RANGE HOOD <br />___ LAUNORY TRAY �__ WATER HEATER <br />__ CLOTHES WASHER ___ METAL FIREPLACE/STOVE <br />__ URINAL ____ FIREPLACE INSERT <br />v DRINKING FOUNTAIN ___ OAS FIREPLACE <br />FLOOR DRAIN _� GAS RANGE <br />___ BACKFLOW PREVENTER __ GAS PIPINO <br />, SINK (SERVICEIBARIMOP/ETG.) �__ EXHAUST �AN <br />__ OTHER � _ OTHER_,_^,�______T <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AN� KNOW THE SAME TO BE TRUE AND CORRECT. AL� <br />PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPEGIFIED HEREI <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL TNE PROVISION OF ANY <br />QTHER STATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE PERFORMANCE OF CCNSTRUCTION. TNAT i AM AUTHORIZED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 19.27 RCW AND 298.200 WAC. <br />Sipnaturo of OwnedContraciorlAuthorfzed Ageni ��G�. �����..� Date OS/08/2007 <br />