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From: 11/76/2010 11 : 11 #136 P.003/004 <br /> -- I <br /> PERMIT APPLICATION 517205 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX <br /> SITE ADDRESS PARCEL TAX I.D,# PERMIT# <br /> 209 60 PL Sr,EVERETT,WA 98203 00794100005300 <br /> LEGAL — LOT NO. BLOCK TRACT <br /> E <br /> OWNER ADDRESS PHONE <br /> I ILISP.R,JERE• 209 60 PL Sr <br /> IiYIiRE•TI',WA 98203 (425)879.473'1 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall 425-636.7054 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> I'AS7 WA I ER HEATER COMPANY 12601 132ND AVE NE <br /> F'ASTW WH948RC <br /> PHONE425.838-7054 KIRKLAND, WA 98034 01/04/2012 <br /> PROPOSED USE OF BUILDING Building Mechenice Addition H AT SOURCE <br /> PERMIT Com6lnatlon Plum Ing WORK Alteration Electric <br /> Residential TYPE Demolition Sign TYPE New <br /> as <br /> CONTRACT PRICE OF WORKRe alrlMalnl Ther <br /> CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION I(emovc/ReplaccGas Water llcntcr <br /> PLUMBING MECHANICAL <br /> P OF FIXTURE ITEM --__O PE OF FIXTURE OR ITEM <br /> WATER CLOSET ___ A1C-A/HANDLING UNITS <br /> BATHTUB _ <br /> LAVATORY (WASH BASIN) _ FORCED AIR SYSTEMS <br /> SHOWER _ HEAT PUMP <br /> KITCHEN SINK 8 DISPOSAL --- UNIT HEATERS <br /> DISHWASHER ------ CLOTHES DRYER <br /> - _ RANGE HOOD <br /> LAUNDRY TRAY 1 WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _� _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN OAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER OAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHEROTHER <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 /> lh <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 /> ICONTRACTORS <br /> THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THESTATE <br /> LAW 18.21 RCW AND 296.200 WAC. <br /> Signature of Owner/Contactor/Authorised Agent <br /> w=rS6,U,�,�td� Date 1126/2010 <br /> UI rel <br />