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Sent By: HP LaserJet 3100; 4258249516; Oct _4.�'� 10:33AM; Page 4/7 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> O <br /> 3200 CEDAR STREET, EVERETT, !VA 98201, 425-257-8810 100405 <br /> SITE ADDRESS PARCEL TAX 1.04 PERMITfI i <br /> 308 60 PL SF,EVCRETT,WA 98203 00794 100001°00 <br /> LEGAL LOT NO. BLOCK TRACT <br /> OWNER ADDRESS PHONE <br /> 308 GO PL SE (4'_5(401.0205 <br /> NGUYEN.SAM EVFREI'I'. 11'A 98'. <br /> TENANT NAME CONTACTNAME PHONE <br /> PAMELA HILL 425 814-31'403', <br /> CONTRACTOR ADDRESS CONTR.UCENSEN <br /> FAST WATER HEA'T'ER COMPANY 12601 132ND AVENE FAST WIICO52DF <br /> KIKKLAND,WA 98034 02116/1007 <br /> (425)814.3124 <br /> PROPOSED USE OF BUILDING Meobenlc WORK Aeeillon H T SOURCE <br /> PERMITlHuutiding <br /> Combinellon P imbin Auuraaon bn^° <br /> TYPE p�rnollUen Pi'n TYPE New <br /> n Re drfM5pAalnl o <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCAL SALES TAX CODE15 3105 <br /> WORK DESCRIPTION RelnovaiReplece Go Water Heatcr <br /> CLUMBINrp AFGHAN CAL <br /> TYP O I E ITFM <br /> F TUR OR <br /> _ WATER CLOSET A1C•A/HANDLINO UN TS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) NEAT PUMP <br /> SHOWER _^_ UNIT HEATERS <br /> KITCHEN SINK 6 DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER __ RANGE HOOD <br /> _ LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE)MOVE <br /> _ URINAL FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN GAS FIREPLACE <br /> F�.00R DRAIN __ GAS RANGE <br /> ______ BACKFLOW PREVENTER OAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC-) EXHAUST FAN <br /> OTHER <br /> IHEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APLICATION AND KNOW THE SAME O BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED W IHT WHETHER SPECIFIED HLREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> 0TH9R STATE OR <br /> OWNER OFF OCAL THIS PROPERTY OLAW TPERFDpN THE WORK OR WHIM I APPLICATION 19 MADE AND 1 COMPLY WIING comSTRUCTION OR THE PEWORMANCE Of CONSTRUCTION.THAT I TH THE STATED <br /> BY <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIBneWnolOv+narlConlnctorlAulhorltedApani �.,- . -' , .., _' r..yY' <br /> Date In.04/2005 <br /> UI M <br />