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Sent By: HP LaserJet 3100; <br />42582A9516; Apr�5-06 10:26A61; Page 3/4 <br />,-�- PEFcMIT APPLiCATIOIv <br />CITY OF EVERETT PERMIT SERVICES <br />,._ 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />oaosor <br />SITE ADDRESS PARCEL TlllC I.D.# PERMIT# � <br />I 1004 17 PL W, I:VF.RF"I"1', WA 982U4 <br />01N!J E R <br />('OCI IP.�1N, HOLLI' <br />NAME <br />00S41GOOOU(�500 <br />ADDRESS <br />i i ooa i 1 rr. t�� <br />• rVEEtF.TT, WA 9ri204 <br />CONTACT NAME <br />PAMHLA H1LL <br />CONTRACTOR ADDRESS <br />PASCWATF.RHEA'I'GRCOMPAKY 126U1132NDAVLA`E <br />�5 S1J-±I7J hlRIiLANll, 1VA 980�4 <br />P �a__ ) <br />PROPOSED US� OF BUILDING tlwmind Mechan�cn WORK <br />PERMIT Cambinullon , P�umElnfl <br />TYPE D�molilion g:An TYP@ <br />WORK OESCRIPTION <br />5449.00 <br />Hemove/lteplace Gas Nater Hca�cr <br />WATER CLOSE7 <br />' THTU6 <br />�,.JATORY (WASH EiASIN) <br />SHOWER <br />KITCHEN SINK R DISPOSAL <br />DISHWASHER <br />LAUNORY TRAY <br />CLUTH[3 WASt-iER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN7ER <br />SINK (SERVICEIBARlMOPlETC.) <br />OTHER______ __ <br />M U(o��l -�5 <br />f'HONE <br />(szs��io-ovzs <br />PHONE <br />42� Sl�-J 12�1 � 131 <br />CONTR.LICENSE# <br />FAS'CN'N'H94SIIl' <br />UI/U3f?U08 <br />SOURCE <br />OF EVERETT LOI:AL SAlE9 TAX CODEIS 3�05 <br />� <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE NOOD <br />WATER HEATER <br />ME7Al fIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPI.ACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER------------------- - <br />I HEREBY CERTIFY TflA71 HAVE RE�D AND E?(AMINED THIS �PLICATION AM1� KNOW THE SAA1E TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF LhWS A4D ORDIMANCES GOVERNING THIS TYPF OF WORK WI�L BE COhiPLIED WIHT WHFTHER SPECIFIEO MERE <br />OR NOT. 7HE GRANTING OF A PEnMIT DOES NOT PRESUME TO GIVE AUTNQRITY 70 V;OLATE OR CANCEL THE PROVISION OF HNY <br />OTHGR STATE OR �OCA; LAW REGULATING CONSTRUCTION OR THE N�RFORMAN� _ UF CONSTRUC710N. TNAT I AM AUTHORIZE� <br />BY THE OWNER OF 7NIS PROP�RTY Tp PERFOftM THE WORK FOR WHICH APPLIGA770� IS MA�E AND I COMP�Y WI7H THE STAI'E <br />CONTRACTORS LAW 16.27 RCW AND 29A.200 WAC. <br />pnnture o( OwnedControctodAuthorizod Agem �,,,� � DaPu , , <br />_. •. �.: �_ ... .�..-�. �s' <_.-.,.'� �' Oq,Oi/_OOG <br />