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P..RMIT APPLICATIL isl <br /> 04� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> CKI Iso <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> to60I'L SE. EVERETT, WA 98203 0079411100005011 Dqc)j <br /> LEGAL LOT NO. BLOCK TRACT <br /> DEQ <br /> OWNER ADDRESS PHONE 1 <br /> PINTLIIR. BRIAN 10 60 PL SE i J <br /> I?VI?It[:TT, WA 98203 (4251423-768) <br /> y <br /> TENANT NAMECONTACT NAME PHONE <br /> PANIFLA IIII-L 425 814.312a x133 } <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAST WATER I WATER COMPANY 12601 132ND AVE NE FASTWHC052DF <br /> PHONE (425)814-3124 KIRKLAND. WA 98034 02/16/2005 <br /> PROPOSED USE OF BUILDING JBulldinp Mechanic& Addition HEAT SOURCE <br /> PERMIT Combination Plumbing WORK Allaatlon Electrlt <br /> TYPE Demolition Slgn TYPENew as <br /> r r Re alr/MalnlOther <br /> CONTRACT PRICE OF WORK S449.1u1 ICITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION <br /> Itrmmc/Replace Cas Wa1tr I Icalcr <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _______ WATER CLOSET A/C-AIHANDLING 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 � WATER HEATER <br /> CLOTHES WASHER --__ METAL FIREPLACE/STOVE <br /> ---_ URINAL FIREPLACE INSERT <br /> —__ DRINKING FOUNTAIN —A_ 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 APLICATION AND 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 HEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE 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 18.27 RCW AND 296.200 WAC. <br /> Signature of Owner/Contractor/Authorizod Agem {_;,� ��- Date 05/188004 <br /> an .v <br />