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I r un: <br />12/20/2�^6 10:04 n758 P.003/003 <br />,- PERMIT APPLICATION <br />�wi�� CITY OF EVERETT PERMIT SERVICES <br />r 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />? I i 7.1 tiT S\Y. IiVIiHl:l'T. 14'A 98.^07 <br />LOT <br />OWNER <br />\fANGll�f, GLOKIG <br />TENANTNAME <br />CONTRACTOR <br />I'AST ll'A'i'I'li IR:A'ffilt CU\11'nNY <br />PHQNE . (•1?S)814-312�1 <br />PROPOSED USE OF BUILDIN <br />CONTRACT <br />WORK DESCRIPTION <br />4RCEL TAX I.D.# <br />OOR34000000700 <br />ADDRESS <br />s i s�a s�r s�v <br />� I'.VF.RI:II�, WA 9R207 <br />CONTACT NAME <br />Pnntcl�i Hill <br />ADDRESS <br />i�r,oi iz�r;unvi_he <br />KIKKLAND, 1VA 98U3d <br />PERMIT1eCombinellon <br />TYpE Domolition <br />$11?.00 <br />Rcmurclicplacc Cias \5'alcr Ilr.itcr <br />OATHTUB <br />LAVATORY (WASH 6ASfN) <br />SHOWER <br />KI7CHEN SINK $ OISPOSAL <br />OISHWASHER <br />IAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT�R <br />91NK (SERVICE/BARlMOPlETC.) <br />O7HER_______ _ <br />T <br />uzou� <br />PERMIT# <br />l�� U� i z- y <br />PHONE <br />�.13 t �?.18-; 3 g < <br />PHONE <br />300 55.1-8��Sa�li} <br />CONTR.LICENSE# <br />PAtiT11'15"I I'i,18[iC <br />UIiU3�:00R <br />Plumhln8 „'�KK Alleratlon <br />61on NPE _ Now <br />LOCAL <br />IuLX�EG4RG1_l, <br />SOURCE <br />eclrlc <br />_______ A1C-A/HANDIING UNITS <br />______ FORCED AIR SYSTEMS <br />____—_ HEAT PUMP <br />____ UNIT NEATERS <br />_______ CLOTHES DRYER <br />___ __. RANGE HOOD <br />___ �__ WATER HEATER <br />—___ METAL FIREPI `CElSTOVE <br />_____. FIREPLACE INSERT <br />___ GAS FIREPLACE <br />_____ GAS FtANGE <br />____ GAS PIPINO <br />_�_ E%HAUST FAN <br />------ OTHER------------- —•- <br />3105 <br />� -------------------- I — --- I — - ---- - ----- --- <br />I NE4EBV CERTIFV THATI MAVF. READ AND E?(AMINED TNIS AVUCATION AND KNOW TH[ SAME TO BE TRUE AND CORRECT AlL <br />PROVISIONS OF LAWS ANO ORDINANCFti GOVERNING THIS TVPF OF WORK WILL BE COMPLIED WIHT WNETH[R SPECIFIEO �tEREIP <br />OR NOT. THE GMNTING OF A PCRMIi DOES NOT PRESUIdG TO GNG AUTHCRITY 1 U VIOLAiE OR CANCEL THE PROVISION OF ANV <br />OThiER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 7ME PEF,FORMhNCE OF CONSTRUCTION. THAT IAM AUTHORIZED <br />OY rHE OWNGR OF THIS PROPERTY TO PERFORM THE WORK FOR WHICHAPPLICATION IS MACE AN� 1 COMP�Y WITH TNE STATE <br />C047RACTORS lAW 18.27 RCW AND 20G.200 WAC. <br />o/ Owner/Controctor/Aulhorizad Agom r--: -� ,_ � � - ' - <br />: .- .- r; �= c'/" .' <br />bete <br />I? J0;200ti <br />Ui v,i <br />