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Pr-on: 10/�1/2006 D9: 16 tl577 P. Q03/003 <br /> L �` <br /> ,-�- P�f�MIT APPLiCATION <br /> � CITY OF EVERETT PERMIT SERVICE� <br /> ,_ 3200 CEDAR STREET, EVERETT, WA 98201 , 425-257-8810 <br /> 1031UC, <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �51� 10 UR �V, LVBRGPT, 1VA 98203 008iG700003600 (�/1 ���� U ,��� <br /> LEGAL LOT NO. BL.00K TRACT <br /> DESC. <br /> OWNER ADDRESS PHONE <br /> 5823 10 DR N' (q25)3d9?531. <br /> l RAN,'fHANH <br /> • I:VERGTT, \VA 95203 <br /> TENANTNAME CONTACTNAME PHONE <br /> PAMGI.A Hll,L 4^_5 814-3124 x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> 1'AS'f WA'I'HRIIEATERCOMPANY 12601 132NDAVENE FAST11'�VII9ASI3C <br /> (A25)614-3124 KIRhLAND, NA 98034 OUO3!?008 <br /> PROPOSED USE OF BUILDING BUI1dIn0 Mechanica WORK Addilion HEAT SOURCE <br /> PERMIT Combinallon PlumClnp AltoraUon [�lElectric <br /> 7'ypE Dnmolillon Sipn TYPE Now �Gas <br /> S Nnk er Ro airMlalnt ther <br /> CON7RACT PRICE OF WORK �449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION Ttemove/Keplace Gas\Varer I-leater <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR I7FM NO. TYPE OF FIXTl1RE OR ITEM <br /> WATER CLOSET ______ A/C-AIHANDLING UNITS <br /> ____ BATHTUB _____ FORCED AIR SYSTEMS <br /> ____ LAVATORY (WASH BASIN) `____ HEAT PUMP <br /> ___ SHOWER �__ UNIT HEATERS <br /> ___ KITCHEN SINK & DISPOSAL ______ CLOTHES �RYER <br /> DISHWASHER _ RANGE HOOD <br /> ___ LAUNORY TRAY ___�__ WA7ER HEATER <br /> CLOTHES WASHER ____ METAL FIREPLACElSTOVE <br /> _ URINAI ____ FIREPLACE INSERT <br /> __ DP:INKING FOUNTAIN - �• - ___ GAS FIREPLACE <br /> _ FLOOR DRAIN 4 ___ GAS RANGE <br /> ___ BACKFI.OW PREVENT�R __. GAS PIPING <br /> ___ SINK (SERVICEIBAR/MOPIETC.) ___ EXHAUST FAN <br /> — _ OTHER_----� ��__ OTHER--------------�-------r. <br /> 1 HEREBY CERTIFY TfiAT 1 HAVE READ AND EXAA1INED THIS F�PLICATION AND KNOW TFI[SAh1E TO BE TRUE AN�CORRECT. 4LL <br /> PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COCdPUED WIHT WNETHER°PEGFIED HEREI <br /> OR NOT.THE GRANTIhG OF A PGRMIT DUES NOT PRESUh1E TO GIVE AUTHORITY TO VIOLAI"E OR CANCEI ThiE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRLICTION OR THE PERFORIdANCE OF CONSTRUCTION.THAT 1 AM AU7HORIZED <br /> BY THE OWNER OF 7HIS PROPERTY TO PERFORAi TH[WORK FOR WHiCH APPLICATION !S�dAOE AND I COhiPLY WITH TI1E S7A7E <br /> CONTk/��CTORS L/1W'I3.27 RCW AND 29fi.200 N'AC. <br /> SlgnaWro of OwnedContrectodAuthorized Agent ,��.::- ��_��,f"C_/. = Date 1�31i2006 <br /> 4f1 an,l <br />