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Sent �y <br />: HP LaserJet 3100; . 4258249516� Sep-5�0` 2:40P!,1; <br />; �- P��MIT AP�LIC�TI�iV <br />�yp�'.'. ClTY QF �VERETT PERMIT SERVtCES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SITE ADbRESS <br />8715 7 AVE VJ, GVLIt!:IT, NiA 9R204 <br />OWNER <br />N�tA711GRH01:�, PHILIP <br />TEMANTNqME <br />CONTRACTOR <br />FAST WATER li[ATCR COMNANY <br />PHONE (^'-s)sla.�tza <br />PROPOSED USE QF I <br />4RCBL TA;( I.I <br />006859(HiUI l 300 <br />AI�DRESS <br />8915 7 AVI. W <br />• EVERETT, WA 482d4 <br />CONTACTNAME <br />pAMEI.A H1LL <br />ADDRESB <br />12G01 132ND AVE NE <br />KIFKLAND, WA 98034 <br />E <br />OF WGRiC S3a9.�o <br />WORK DESCRIPiION �Lemoce�Rcolace L• lectric Wu:cr Hca:er <br />____ WATER CLOSGT <br />_____ BATHTUB <br />____„ lAVA70RY (WASH BASINI <br />____,_ SHOWC•R <br />____ KI7CHEN SINK 6 UISPOSAL <br />,___ DISHWASHER <br />LAUNDNY TRAY <br />T� GLOTHES WASHER <br />___ U��INAL <br />_____ DRINKIMG FOUNTAIN <br />�_.� FLOOR DltA1N <br />_____ �ACKFLOW PREVENTER <br />______ SINK (SERVI�E/BARIMOPl6'fC.) <br />__�_ OTHER� <br />P�um6lny WaRI <br />Sipn TVP[ <br />Page 3/3 <br />U'JO705 <br />PERMITi <br />JYl c�5 � -r� � <br />PHONE <br />(4'-,5)753-.�326 <br />PHONE <br />425 8t4-7124+c133 <br />CONTR.LICENS <br />F; , S'f WFIC052U1' <br />02,' i G�?007 <br />idl0on H�AT 90URC <br />teratlon C1Electdc <br />OF EVERETT I.00AL SALES <br />, ____ FORCED AIR SYSTEMS <br />_.��_ fiEAT PUMiP <br />____ UNIT HEATERS <br />_______ c�o7HB5 DRYER <br />__ ltANGE HOOD <br />___�__ WATER HEATER <br />_____ METAL FIREPLACElSTOVE <br />._�___ FIREPLACE INSERI <br />__._ 6AS FIREPLACE <br />_�_ GASRANOE <br />_`_ GAS PIPINO <br />. ___ EXHAUST FAN. <br />---- OTHER-------. . <br />� <br />3105 <br />--- j. -- -- -- i --' - i - — ' --' - <br />I MEREBY CERTIFY THAT I MA\'E READ AND EXAMINED THIS APUCAiION ANi) KNOW THE SAME TO BE TRUE AND CARRECT All <br />PROVISIONS OF LAWS AN� OR�IMANCES GQVERNING THIS TYPE OF WORi; WILL 6E COMPUED WINT WHE7'HER SPEC�PIEO MERE <br />OR NOL THE GRANTING OF A PER1,11T DOES NOT PRESUME TO GNE AUTHGRITY TO VIOLATE OR CANCEL TFiE PROVISION OF ANY <br />OTHEA STATE OR LQCAL lAW REGUTATING COWSTRUCTION OR THE PERFJRhW�CE OF CONS7RL7CTION. S'HAT IAM AUTHORIZED <br />8Y THE OWNER OF THIS PROPERTY TO PERFORM 7HE WQRK FOR WNICH:IGPLICATION IS MAOE AND 1 COMPLY WITH TN'c STATE <br />CONTRACTORS LAW 1g.27 RCW AND 298200 WAC. <br />of OwnerfConVactorlAuthorized Ageni �.�_-: �.r_ ,�. _^� f,-- pate 09/OG2005 <br />ui wi <br />