Laserfiche WebLink
Sent By: HP LaserJet 3700; 4258249576; Jun-23-06 8:54AlA; Page 2/2 <br /> ,--� P�RMIT APPLI�A�IC�N <br /> i,���� GITY OF EVERETT PERMIT SERVICES <br /> F 320Q CEDAR STREET, EVERETT, �NA 98201, 425-257-8810 <br /> oG2.anG <br /> 5l7E ADDRESS pARCEL TAk: t.D.# pERMIT# <br /> zsi_s s�r. �vei:c�rr�, �vA �,szoi uuaenouuu�3ua <br /> lM l�o[� -SC� <br /> IEGAL � LOT MO. BLOCK ITRACT <br /> DE � , <br /> OWNER ADDRESS PHONE <br /> zs<<s s•r , <br /> CARLtiON,G�R'f (J2>j?i9-4fi42 i <br /> FVERETT,WA 98?01 <br /> TBMANT NAME CONTACT NqME PHONE � <br /> T()M (SON IT� LAW) PAh4G[.AIIILL 425 S14•31?4 n13� <br /> CONTRACTOR ADDRESS CONTR,LICENS�# <br /> FA.ST N4\'I'EK HF:.A'1'eFt COA11'ANY 12601 132ND AVE NE Fi1ST\VR'H94RRC. <br /> (4_'S)814-3124 K1KICLAIJU, N'A 48U�i4 pl/03/20(1R <br /> PROPOSfiD USE OF SUILDING 9u��dinp MncbaMea qddld0� H 7 SouRCE <br /> PERMIT Comhlnallon PI�m6fng wORK q��atation Eleclric <br /> TYPE �amolillon Slgn TYPE New ac <br /> r I R� alrlMalnt ther <br /> CONTRACT PRICE OF WORK j3qy,UU CITY OF EVERETT LOCqt SALES 7AX CODEIS 3105 <br /> WORN DESCRIPTION �temove/Replam Electric VF'ater He:ucr <br /> PLUMBING 1,fECHANiCAL <br /> TYP OF FIXTURE OR ITEM NO. TYPE OF FIXTUR OR ITEM <br /> ____ WATER CLOSET ____„__ A/C•A/HANOLING UNITS <br /> ______ BATHTUB .______ FORCED AIR SYSTEMS <br /> ______ LAVATORY (riASH BASIN) ._�___ HEAT PUMP <br /> _______ SHOWER __� UNIT HEATERS <br /> ______ KITCHEN SINK & OISPOSAL _______ CLOTHES DRYER <br /> ___�__ DISHWASHER _ _ RANGE HOOD <br /> __,__ LAUNORY 7RAY __1 _ WA7ER HEATER <br /> _�__ CLOTHES WASHER __� METAL FIREPLACElSTi)VE <br /> ___ URINAL __�_ FIREPLACE INSERT <br /> �__ DRINKING FOUNTAIN ______ GAS FIREPL4CE <br /> _ FLOOR DRAIN ____ GAS RANGE <br /> _�__ BACKFLOW PREVENTER .__: GAS PIPING <br /> ___ SINK (SERVICEIBAR/MOPIETC.) __�_ EXHAUST FAN <br /> --__ DTHER-----�.__ _ O7HER------------------ <br /> I HEREBY CERTIFY THAT 1 NAVE RFAD AND E%AMIhEO THIS APLICATION ANq KNOW THE SAME TO BE TRUE AND CORREC7.nLL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE O�WORt:WILL BE GOMPLIED W IHT WMETHER SPECIFIED HEREI <br /> OR NOT. T1iE GRqN11NG OF A PERMIT DOES NOT PRESUME TO GNE AUTHC�RIN TO VIOLATE OR�ANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL U�W REGUTATING CONSTRUCTION pR THE GERF4RMFWCE OF CONS7RUC710N,THAT I AM AU7HORIZED <br /> 9Y THE OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICr1 APPLICATION IS MA(]F. AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 19.27 RCW AND 298.20�WAC. <br /> Slgnaturo of ownodContrActor/Authorized Agem �,,,_� :._,_- .,;,._�•�' ,.: Date �6/23/2UOG <br /> W� .v <br />