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P.,RMIT APPLICATK,N <br />CITY OF EVERETT PERMIT SERVICES <br />4,—rrr <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />cK1x5x <br />SITE ADDRESS <br />PARCEL TAX I.D.# <br />PERMIT# <br />I 11 74 ST SE. EVERETT, WA 9x2os <br />00392000002302 <br />G�Gt-I'OG� <br />LEGAL <br />LOT NO. <br />BLOCK (TRACT <br />DE <br />OWNER <br />ADDRESS <br />PHONE <br />I'IITFRS, GLORIA <br />111 74 ST SF- <br />(425)3534492 <br />EVERETT. WA 98205 <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />1'ANIFLA IIII.L <br />425 914-3124 xl33 <br />CONTRACTOR <br />ADDRESS <br />CONTR.LICENSE# <br />PAST WATER I IEATI?It CONII'ANN' <br />12601 132ND AVE NE <br />FAST\VIIC052DI' <br />KIRKLAND. WA 98034 <br />02,16/2005 <br />PHONE (425)814.3124 <br />PROPOSED USE OF BUILDING <br />Bullding Mechanics <br />'Plumbing <br />WORKtAAjd <br />dition <br />HE TSOURCE <br />PERMIT <br />Combination <br />let on <br />Eloddc <br />TYPE <br />D•molilion Sign <br />TYPENow <br />a• <br />r r <br />Ra alrlldaint <br />iher <br />CONTRACT PRICE OF WORK S349.00 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION ltcmot,c/Replace lilectrie Watcr IlealcT <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO, I TYPEOF FIXTUR C1R ITEM <br />WATER CLOSET <br />—----- <br />A/C•A/HANDLING UNITS <br />BATHTUB <br />—----- <br />FORCED AIR SYSTEMS <br />____ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />—___ <br />UNIT HEATERS <br />KITCHEN SINK 6 DISPOSAL <br />CLOTHES DRYER <br />DISHWASHER <br />__ _ <br />RANGE HOOD <br />LAUNDRY TRAY <br />_____l__ <br />WATER HEATER <br />CLOTHES WASHER <br />--___ <br />METAL FIREPLACE/S'rOVE <br />URINAL <br />—__—_ <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />--_ <br />GAS FIREPLACE <br />FLOOR DRAIN <br />—___ <br />GAS RANGE <br />BACKFLOW PREVENTER <br />--_ <br />GAS PIPING <br />--____ - <br />SINK (SERVICEISAR/MOP/ETC.) <br />_—_ <br />EXHAUST FAN <br />OTHER--------- --- <br />OTHER--------------------- <br />1 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 HERE( <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 TOR WHICH APPLICATION IS MADE AND I COMPLY WITI- THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Signature of Owner/Contractor/Authorized Ageni ��.>>-_� �- Date 03i31/2004 <br />