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frnn: <br />04/16/2009 12:09 p140 P.003/003 <br />PERMIY APPLICATION <br />��i�� CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201, 425-257-8810 <br />425-257-8857 FAX <br />�r��www�ww _"___"—"'__ . � <br />240G I 16 ST SI:, CVI�:RI;"I"I�, WA 9R208 <br />OWNER <br />p01UI.AS, Ml'fC11G1.1. <br />P.4ti'I' 1VA1'lifi IIIiA'I�LR CUMI'AN5' <br />00400500000�11 <br />ADDRESS <br />2A06 1 IC, S7' SE <br />� IiV1iRf�I'I', WA 9R208 <br />�CONTACT NAI <br />I Carol Randall <br />12601 132NU AVIi Nh: <br />425-636�7054 I:IItKI.ANU, WA 9N034 <br />PHONE <br />PFiOPOSED USE OF BUILDING ew�a�no M <br />PERMIT ComEln�llon pl <br />TVPE D�molllion 81 <br />CONTRACT PRICE OF YUORK a449.00 C <br />WORK DESCRIPTION Hi��������Repince (ias Weter Ilealer <br />BATHTUB <br />LAVATORY (WASH DASIN) <br />SIiDWER <br />KITCNEN SINK 6 DISPOSAL <br />DISNWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBAR/MOP/ETC,) <br />oTHER�__ ____ <br />� <br />WORK <br />441044 <br />C-�ic�i c�1� <br />PHONE <br />(425)338-3742 <br />PHONE <br />425-�36-7054 <br />CONTR.LICENSE# <br />1'AS�I-W W1194NfiC <br />01/04/2010 <br />A/C-A/HANDLING UNITS <br />FORCED AIR SYSTEM9 <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER MEATER <br />ME7AL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />OA9 FIREPLACE <br />GASRAN6E <br />OAS PIPINO <br />EXHAUST FAN <br />OTHER_____ _ <br />SOURCE <br />7105 <br />I HEREAV CCRfIFV THAT I HAVF. READ AND EXAMINED THIS APUCATION ANO KNOW THE SAME TO BE TRIIE ANO CORRECT ALL <br />PROVISIONS OF t.AWS AN� OR�INAhCES GOVERYING 7NIS TVPE OF WORK WILL BE COMPLIEO WIHT WNETHER SPECIFIED HERE <br />OR NOT. THE GMNTING OF A PERMIT DOES NOT PRESUME TO OIVE AUTHORITV TO VIOLATE OR CANCEI THE PROVISION OF ANV <br />OTMER STATF: OR �OCAL lAW REC>UTATING CONSTRUCTION OR THE VERFORMANCE OF CONSTRUCTION. THAT I AM AUTMORILED <br />BY THE OWY[N oc TIilS PRONkRtY 70 PERFORM THL WORK FOR WHICHAPPLILATION IS MAOE AND I COMPLY WITN TNE STATE <br />CONTRACtoRS.qW 1(1.27 HCW ANU 296200 WAC <br />of OwnodContrecWrlAulhori:ed Apent <br />Cv,..�PlY)L.�,..I�rIF DMs �,�/1G/2U09 <br />u� .ai <br />