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Sent By: HP LaserJet 3100; <br />4250249576� "Aar-c-�o 4:20PM; Page 3/3 <br />PEklVI17 APPLI�ATION <br />����' CITIr' OF EVERETT PERMIT �ERVICES <br />3200 CEDAR STREET, EVERETT, 'NA 98201, 425-257-8810 <br />o.3a�ne <br />SITE ADaRESB PARCEL TN( I,6.# PERMIT# <br />11018 17 pl, W, F.VF.RF,TT, W� y8204 0084160D000 �00 ��� G3�L� <br />i <br />OWNER <br />�YtAltTll�. DAVID <br />TENANT NAME <br />ADDRESS <br />11018 17 PL W <br />�VERF,'1'I', WA 98204 <br />CONTACTNAME <br />PAtitELA HILL <br />CONTRACTOR IADDRESS � <br />FAST \YATER fIEATER C0�1PAT.Y 12C�(Il 132ND AVE NE <br />(425)81d•312d KIRKLAND, N'A 98U34 <br />PROP05ED US� OF BUILDING Bulldinp M��chanloe <br />PERMIT Cembinmion P�imclnp WaRI <br />TYPE ormvUtbn 3iqn TYP� <br />ri r <br />CONTRACT PR�CE OF WORK �qq9.00 CiTY oF E1/HFE' <br />1YORK DESCRIATION [temove/Replacc Gas Wetcr Hce�cr <br />WATER CL09ET <br />BATHTUB <br />IAVATORY (WASH BA51N) <br />SHOWER <br />KITCNEN SINK 6 DISPOSAL <br />DISNWA3HER <br />!_AUNORY TRAY <br />CLOTHE9 WASHER <br />URINAL <br />DRIkKING fOUN7pIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT6R <br />SINK (SERVICE/BAR/MOPlETC.) <br />OTNER __ <br />- � — <br />PHQkE <br />(435 )3'3-4757 <br />PHONE <br />4?5 814-J1Z4 x])i <br />CONTR.LICENSEJ� <br />1'AS'P\V W I 1948BC <br />O l /OJ/.008 <br />E <br />COOE <br />FORCED AiR 3YSTEMS <br />HEA7 PUMP <br />UNIT HEATERS <br />CLOTHES ORYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACEfSTOVE <br />FIREPIACE INSERT <br />GAS FIR�PLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTH ER----------------- <br />MEREeY CERTIFY THqT I HAVE READ ANO EXA,MINEp THIS Ap�ICAT10k AN_] KNOW 7HE SAME TO 6E TRIIE AND CORRECT. ALL <br />'ROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HI5 TYPE OF WORr; WILI BE COMPLIEO WIHT WHETNER SPECIFIEO MERE <br />)R 40T. T1iE GRANTiNG OF A PERMIT OOES NOT PRESUME TO ONE AUTHC'RIIY TO VIOU�TE OR CANCEI THE PROVISION OF ANY <br />ITNER STATE OR LOC/+L LAW REGUTATING CONSTRUC710N OR THE PERF•)RMANCE OF CONSTRIICTION. THAT IAM AUTHOfiIZED <br />',Y THE OWNER OF THIS PROPERTY TO PERFORM THE WQRK FOR WMICH APP6ICATION IS MAOE AND 1 COMFLY WITH THE STATE <br />:ON7RACTORS LAW 19.27 HCW AND 2M,200 WAC. <br />of OwnorlContractorfAuthorized Agani �,_, �-�: �,, : -` ,r, <br />� <br />Data 03/06/2WG <br />N�Iv <br />