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,-� � FF2MIT APPLICAT'�JN <br />��i�CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />018941 <br />SI7E ADDRESS PARCEL TAX I.D.# PERMIT# <br />7 7i tiT S11', fiVl?RETT.11'A 9R203 00792400001700 m03�q —�Z�i <br />LEGAL LOT NO. BLOCK TRACT <br />OWNER AODRESS PHONE <br />�oti�:son�, rcRi � �s sr sw (4Z5)355•7337 <br />• EVGRCTT, WA 4H2O3 <br />TENANT NAME CONTACT NAME PHONE <br />PAA1[LA HILL 425 814-3124 x1J3 <br />CONTRACTOR ADDRESS CONTR.LICENSEp <br />PAST �YATf3R HBATER COMPANI' 12601 132ND AVG NG FASTWHC052DF <br />KIRKLAND, WA 98014 02/16/2005 <br />�azs�sia-�iza <br />PROPOSED USE OF BUILDING Bulldinp - M�ehanic� WORK Addillon H T 30uRCE <br />PERMIT Combin�llon Plumbinp All�ratlon El�cl�ic <br />7YPE D�molillon Sipn TYPE Naw �� <br />R� elrlMalnl tber <br />CONTRACT PRICE OF WORK 5449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 7105 <br />WORK DESCRIPTION Rcmovc/Rcplacc Gas Watcr Hcatcr <br />PLUMBING MECHANICAL <br />OF TU I E OF XTUR R ITE <br />----- <br />WATER CLOSET ______ A1C•AIHANDLINO UNITS <br />BATHTUB ______ FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) ____ HEAT PUMP <br />� SHOWER ___ UNIT HEATERS <br />KITCHEN SINK 3 DISPOSAL _�__ CLOTHES DRYER <br />DISNWASHER _ RANGE HOOD <br />LAUNDRY TRAY __�__ WATER HEATER <br />CLOTHES WASHER _! METAL FIREPLACEISTOVE <br />� URINAL _�_ FIREPLACE INSERT <br />DRINKING FOUNTAIN ___ OAS FIREPLACE <br />� FLOOR DRAIN _`_ GAS RANGE <br />BACKFLOW PREVENTER __ (3AS PIPINO <br />-- --- <br />SINK (SERVICFJBAR/MOPIETC.) ___ EXHAUST FAN <br />_ OTHERA ______ OTHER-------------------- <br />I NEREBY CERTIFV TFIAT I MAVE READ AND EW+MINEO THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF lAWS AN� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WMFTN[R SPECIFIED MEREI <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE AUIHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR IOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO <br />BY THE OWNER OF THIS PROPERTY TO PERFORM TME WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITN TME STATE <br />CON?RACTORS LAW 18.27 RCW AND 298200 WAC. <br />Signalure of OwnedContracrorlAuthorized Ageni ����� �r.��- D�te 09/I I/2003 <br />