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Sent BY: On LaserJet 3100; <br />4258249516; Sep :45AIA; Page 2%3 <br />-- PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, `NA 98201, 425-257-8810 <br />or_!o5 <br />SITE ADDRESS <br />PARCEL TAX I.D.# <br />PER►,; T: <br />615 7_ Sl SL k47C, LVERETT. WA 98203 <br />00683200304.00 <br />LEQAL LOT NO. BLOCK _ )TRACT <br />-- <br />OWNER ADDRESS PHONE <br />I-OX, AARI A 615 75 STSE #47C' (125)353.7131 <br />LVEKE]'I-,WA 98203 <br />TENANT NAME - CONTACT NAME PHONE <br />_ PAMELA HILL 425 814-3124 v133 <br />CONTRACTOR ADDRESS CONTR.LICENSER <br />PASTWATFRHEATER COMPANY 2501132NDAVENE FASIAV11CO52DF <br />NIRKLAND. WA 98034 U;/1612007 <br />ONE (425)614.3I24 <br />PROPOSED USE OF BUILDING Bulldlno M•IchmIc Addition H AT SOURCE <br />%mbindbn WORK <br />' I'd Don <br />PGRMIT Fl Inlbllq Allnstlon Nudc <br />TYPE b1,In TYPE Now i�r,c <br />t Ro mIfIMUnI IhH <br />CONTRACT PRICE OF WORK 5349.00 <br />..—� <br />C TY OF EVERETT LOCAL SALES TAX CODES 7105 <br />WORK DESCRIPTION Rcmuve/Replace Llectric Water Fleeter <br />T <br />11MBl <br />MECHANICAL <br />NO, TYPE OFIXTURE I <br />. j <br />, ______ <br />T O IKTURE OR ITEM <br />AIC•AIHANDLING UNITS <br />WATER CLOSET <br />BATHTUB <br />, <br />FORCED AIR SYITEMS <br />LAVATORY (WASH BASIN) <br />. <br />HEAT PUMP <br />SHOWER <br />_—_ _ <br />UNIT HEATERS <br />KITCHEN SINK 6 DISPOSAL <br />, <br />CLOTHES DRYER <br />DISHWASHER <br />_ _ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />____ <br />METAL FIREPLACEISTOVE <br />T <br />URINAL <br />___ <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />_ � <br />OAS FIREPLACE <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFI.OW PREVENTER <br />___ <br />GAS PIPING <br />SINK (SERVICE/BARtMOPIETC.) <br />_ __�_ <br />EXHAUST FAN <br />OTHER -------------------- <br />I HEREBY CERTIFY TIIAT I HAVE READ AND EXAMINED THIS APLICATION AN') KNOW THE SAME TO SE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WOR'< 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 RFGUI ATING CUNSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED <br />I5Y THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION 19 NtAOF AND ICOMPLY WITH THE STATE <br />CONTRACTORS LAW 18 27 RCW AND 298.200 WAC <br />Slpnsturo of Own@r/Canlractor/Autharind Agee! ' ' Date <br />