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Irun: 07/14/2009 10:09 P273 P. 002/002 <br /> PERMIT APPLICATION 451085 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE.TT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 232 60 PL SE, EVERET-r, WA 98203 00794100004400 <br /> 0I(� "1�; - OLU <br /> GAL LOT NO. BLOCK TRACT <br /> SC. <br /> OWNER ADDRESS PHONE <br /> 232 60 I'I. SI; <br /> L'111.VER, PAl1L (425)355.7775 <br /> _ IiV1iKETI', WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall_ _ 425.636-7054 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAST'WA"1 ER HEATER COMPANY 12601 132ND AVE NE FASTWW1194813C <br /> PHSlM_ <br /> 425-636-7054 KIRKLAND, WA 98034 01/042010 <br /> PROPOSED USE OF BUILDING Building Machanlca Addlllon H T SOURCE <br /> PERMIT Comhlnalion Plumbing WORK IUleraeon Electric <br /> TYPE Demolition Sign TYPE New as <br /> Re ah/Malnt her <br /> CONTRACT PRICE OF WORK 5449.00 CITY OF EVERETT'-OCAL SALES TAX CODEIS 7105 <br /> WORK DESCRIPTION Remove/Replace Oas \Vater llcatcr <br /> PLUMBING MECHANICAL <br /> TYPE OF FIXTURER ITEM NO, TYPE OF FIXTURUR ITEM <br /> WATER CLOSET __ ___ A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) _ HEAT PUMP <br /> SHOWER V _ UNIT HEATERS <br /> _ CLOTHES DRYER <br /> KITCHEN SINK b DISPOSAL <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY 1 WATER HEATER <br /> ______ CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL __ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICE/PAR/MOP/ETC.) _ EXHAUST FAN <br /> DTHER_______ <br /> OTHER______ <br /> I r.�REBY 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 10 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 /> 13Y THE OWNER OF THIS PROPERTY 10 PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Signature of Ownor/Contractor/Authorized Agent r-ay....��r'jr7Cif3">ii....,(ceta Date <br /> 07/14f2009 <br /> u�w <br />