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From: �4/14/?010 14:45 N708 P.002/002 <br /> PERMIT ApPLICATION 488005 <br /> CITY OF EVERETI� PERMIT SERVICES <br /> .._ . 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX y�,f�/�/j� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 4711 5 AVE W,LVBRETT,WA 98203 00767900001500 <br /> �l 1�y - '� t'�- <br /> LEuAL LOT NO. BLOCK TRACT <br /> OWNER ADDRESS PHONE <br /> TRUJiI.LO,KAREN 47ll 5 AVE W (425)773-5509 <br /> • fiVGPTT'T, WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall 425-636-7054 <br /> CONTRAC'iOR AD6RESS V CONTR.LICENSE# <br /> FAST WAT'Glt}iEATER COMPANY 12601 132ND AVE N� FASTW WH948IIC <br /> KIRKLAND,WA 98034 Ol/04/2012 <br /> 425-636-7054 <br /> PROPOSED USE OF BUILDING euimtno M�chani0a WORK '4ddlllon N T SOURCE <br /> PERMIT Com6lnslion Plumbin All�ntlon EI�aMc <br /> Residential TypE Damoli�ian Slyn TYPE New as <br /> Rs efrlMalnt her <br /> CONTRACT PRICE OF WORK $q49.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION R�movc/Replacc Gas Water Heater <br /> PLUMBING MF,�HANICAL <br /> TYP OF I TU 1 EM NO. OF XTUR R ITE <br /> ,__ WATER CLOSET ____ A/C•A/HANDLIN6 UNITS <br /> __ BATHTUB _____ FORCED AIR SYSTEMS <br /> ___ LAVATORY (WASH BASI,N) __�_ HEAT PUMP <br /> _.. SHOWER �__ UNtT HEATERS <br /> ____ K�TCHEN SINK 6 DISPOSAL __,_ CLpTHFS DRYER <br /> __ DISHWASHER _ RANGE HOOD <br /> ,�__ LAUNORY TRAY i _ WATER HEATER <br /> �__ CLOTHES WASHER ___ METAI FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN OAS FIREPLACE <br /> FLOOR DRAIN _� GAS RANGE <br /> _ BACKFLOW PREVENTER GAS PIPlNO <br /> _ SINK (SERVICE/8AR/MOP/ETCJ - ___ EXHAUST FAN " <br /> ___ OTHER __ ___ OTHER_____�_��_T <br /> I FiEREBY CERTIFY TfiA71 HAVE READ AND E%AMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE.4ND CORREC7.ALL <br /> PROVISIONS OF LAWS AND OROINANC[S GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CAMCEI THE PROVISION OF ANY <br /> OTHER STATE�OR LOCAL l/1W REGULA7ING CONSTRUC710N JR THE PERFORMANCE OF CONSTRUCTION.TNAT I AM AUTHORIZED ! <br /> BY TNE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICHAPI'LICATION IS MAOE AND 1 COMPLY WITH THE STi�TE <br /> CONTRACTORS LAW 16.27 RCW AND 298.200 WAC. <br /> Signature of OwnedContnctor/Authorized Ageni � ����,,,�Qp Data 04/14/2010 <br /> uta� <br />