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Iron: 03/119/2008 13:33 #671 P. 002/002 <br /> PERMIT APPLICATION 396813 <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 /> 21 60 111.SE, EVERE1-17,WA 98203 00794100002900 <br /> LEGAL LOT NO. BLOCK TRACT <br /> OWNER ADDRESS PHONE <br /> DOBSON,KEN&ELIZABETH 2160 PL Sr <br /> I. EYERETT,WA 98203 (425)265.1294 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall 800-454-8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAST WATER HEATER COMPANY 12601 132ND AVE NE FASTW W11948BC <br /> PHONE 800454-8955 KIRKLAND,WA 98034 01/04/2010 <br /> PROPOSED USE OF BUILDING Building Maehanlgea WORK Addition HEAT SOURCE <br /> PERMIT Combinelion Plumbin Alteration EleeMc <br /> TYPE Demollllon Sign TYPE New as <br /> Sprinkler Ra air/Malnl her <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION Remove/Replace Dae Water Heater <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEPA NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A1C•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 1WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN ' _ OAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER__ OTHER-------------- <br /> I <br /> THER__ --___-_-_-1 HEREBY CERI IFY 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 HEREIN <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND t COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 288.200 WAC. <br /> Signature of Owner/Contractor/Authorized Agent '7/�f� ,,gyp Date 03/0512008 <br />