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from: 06/�'�2007 10:38 tl601 P. 004/004 <br /> PE��MIT APPLICA�"I�ON 369062 <br /> CITY OF EVEl2ETT PERMIT SERVICES <br /> `„ 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX <br /> SITE A�DRESS PARCEL TAX I.D.# PERMIT# <br /> 9112 10 AVE SE,GVEItETT,WA 98208 006G3700001600 �� � F^� /� — ' � <br /> �.�A <br /> LEGAL LOT NO. BLOCK ITRACT <br /> D <br /> dWNER ADDRESS PHONE <br /> 91 l2 10 AVG SB �5 347-508G <br /> "CISH,MARGAItET . ��y2ET"I',WA 98208 ��� � <br /> TENANTNAME CONTACTNAME . PHONE <br /> ?amela Hill 800-454-8955 x 133 <br /> CONTR.4CTOR ADDRE&S CONTR.LICENSE# <br /> PAS'PWATGRHEATGRCOMI'ANY 1?601132NDAVENG FASTWWH948DC <br /> KIRKLAND,WA 98034 O1/03/'1008 <br /> (425)814-3124 <br /> PROPOSED U5E OF BUILDING �ulidlnp Machanlca W�RK Additlon HEAT SOURCE <br /> PERMIT Combinatlon Plumbinp Allare6on Elect�ic <br /> 'rypE oomolilion Slpn TYPE New ac <br /> rinkle Re nirlMaint thcr <br /> CON7RACT PRICE OF WORK y349.00 CITY OF EVERETT LOCAL SAIES TAX CODEIS 3'105 � <br /> WORK DESCRIPTIDN Remove/Repince Electric Water Heater <br /> PLUMBING MECNAt:1CAL <br /> N . TYPE OF FIXTURE OR ITE NO. TYPE OF FIXTl1RE OR ITEM <br /> � WATER CLOSET _�___ AIC-A/HANDLIN3 UNI7S <br /> BATHTUB __�_ FORCED AIR SYSTEh1S <br /> ____ WVATORY(WASH BASIN) _ HEAT pUMP <br /> SHOWER __ UNIT HEATERS <br /> KITCHEM SINK 8 DISPOSAL _ CLOTHES DRYER <br /> D�SHWASHER RANGE HOOD <br />` LAUNDRY TRAY _�__ 4NATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEfSTOVE <br /> � URINAL _�_ FIREPLACE INSERT <br /> DRINKING FOUNTAIN ___ GAS FIREPLACE <br /> FLOOR DRA1N ______ GAS RANGE <br /> BACKFLOW PREVENTER _� GAS PIPING <br /> ____ SINK (SERVICEIBARIMOP/ETC�) .___ EXHAUST FAN <br /> _ OTHER ____ OTHER__ ________ <br /> t HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICpTION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PftOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIFO WIHT VJHETHER SP6CIFIED MEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVG AUThiORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATIN3 CONSTRUCTION pR THE PcRFORMANCE OF CONSTRUCTION.THAT I AMAUTHORIZEO <br /> BY THE OWNER OF THIS PROPERIY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPIY WITH THE STA7E <br /> CONTRACTORS LAW 18.27 RCW ANO 296.200 WAC. <br /> Signaturo ot OwnerlContracmr/Authorizad Agent �.�;��. ��--����,� Oate 06107/2G07 <br /> u� orsi <br />