Laserfiche WebLink
Sent By: HP LaserJet 3100; 4258249516; Jan-4.06 10:31AM; Page 3/4 <br /> PLRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, `NA 98201, 425-257-8810 <br /> 010406 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 1028 59 PI SW',EVERE 11. WA 98203 00836700004 00 /nn <br /> LEGAL LOT NO. BLOCK TRACT `/'( 1J <br /> OWNER ADDRESS PHONE <br /> IUVORD.SUE&DUNN.JERLMY 1028 59 PL SIV <br /> • EVERET 1 WA 98203 1425}1117.059.2 <br /> TENANT NAME CONTACTNAME PHONE <br /> PAMELA HILL 425 814-3124x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAST WATER HEATER COMPANY 12601 132NDAVF NE FASrWHCO52DF <br /> PHONE (42S)614-3124 KIRKLAND,WA 98034 02115,7007 <br /> PROPOSED USE OF BUILDING pMochenl0ee WORKNR*palr#Aalnt <br /> Adi111on AT SOURCE <br /> PBRMITJHBulldln <br /> Combination Plumbin Altarafic Imcldc <br /> TYPE Damolibon SIL" TYPE Now as <br /> UnnMer n r <br /> CONTRACT PRICE OF VVORK $449.00 CITY OF EViRfTT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION Rem 1rc/Rep ace Das Water Healer <br /> PLUMBING &ECHANICAL <br /> NO. TYPE OF FIXTURETYPE or 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& DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER _-_ _ RANGE HOOD <br /> LAUNDRY TRAY IWATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> _ FLOOR DRAIN GAS RANGE <br /> _____ RACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER _ OTHER_____---_--_—_ <br /> I HEREBY CCRTIFY THAT I HAVE READ AND EXAMINCO THIS APLICATION ANC KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREIN <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHO I"TO VIOLATE OR CA4CEL THE PROVISION OF ANv <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFCRMANCE OF CONSTRUCTION.THAT MA AUTHORIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICHAPPLICATION IS k"Ll AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.77 RCW AND 296 200 WAC. <br /> Signature of Ownor/Contruelor/Aulhorized Agenl �,._ '�. / Date 01'042006 <br /> u,.m <br />