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fTon: 10/22/'006 14:04 0316 P.003/003 <br /> PERMIT APPLICATION 419055 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX D<;t3 —dk <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 1.329 57 ST SW, RVRRF:I-F, WA 98203 0084;701800100 lif 7 (u _ <br /> LEGALLOT NO. KOCK (TRACT <br /> OWNER TADDRESS PHONE <br /> PARKIN, URIAN I 1329 51 ST SW (425)407.8712 <br /> IfV1:R1:'I'F, WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall 800-454-8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAST WATER IICA I Lit COMPANY 12601 132ND AVE NL FAS1'WW1194hIIC <br /> PHONE 800-154-8955 KIRKLAND, WA 98031 01/04/2010 <br /> PROPOSED USE OF BUILDING <br /> Building Mochanica WORK Addldon H AT SOURCE <br /> PERMIT Combination Plumbinp IVlaiadon 4cldc <br /> TYPE OamoIIMon Sipn TYPE Naw as <br /> Re alrlMalnl Cher <br /> CONTRACT PRICE OF WORK 5449.00 CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> WORK DESCRIPTION Remove/Replace Gas Water Hcnlcr <br /> PLUMBING MECHANICAL <br /> TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET AIC-A/HANDLING UNITS <br /> _____ BATHTUB FORCED AIR SYSTEMS <br /> ____ LAVATORY (WASH BASIN) HEAT PUMP <br /> ----- SHOWER UNIT HEATERS <br /> KITCHEN SINK d DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY _ _ WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL _--_ FIREPLACE INSERT <br /> DRINKING FOUNTAIN —_ GAS FIREPLACE <br /> _ FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER --__ GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) —__ EXHAUST FAN <br /> --- OTHER---- --- --- OTHER------------------ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS API,[CATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TY?E OP WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HERE( <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO LAVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR'i HE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 15.27 RCW AND 296 200 WAC. <br /> Signaturo of DWner/ContractorlAulhorlLed Agent %;,v w ,/,45�4-...GrDate 10/228008 <br />