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From: 01/30/2008 16:11 9634 P.002/002 <br /> PERMIT APPLICATION 391860 <br /> CITY OF EVERETT PERMIT SERVICES <br /> .._ 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX I-3/-0e <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 1214 58TH ST SW 4B,rVERETT, WA 98203 00868100400200 <br /> 111 '. x'/ <br /> LEGAL LOT NO. BLOCK TRACT <br /> D <br /> OWNER ADDRESS PHONE <br /> 1214 58TH S1'SN'PBIAMS, BARBARA fi MARK (425)407-0738 <br /> EVERETT,WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> STAND REMOVABLE Carol Randall <br /> 80054-8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAST WATER HEATER COMPANY 12601 132ND AVL'NE FASTWW14948BC <br /> PHONE 800454-8955 KIRKLAND,WA 98034 01/04/2010 <br /> PROPOSED USE OF BUILDING ectlldinp Mechenlcs Ar00on H T SOURCE <br /> PERMIT Combinstion Plumbing WORKHRedpalr/Maln,Alteration Eleclnc <br /> TYPE Demollllon Sign TYPE New as <br /> ILDSprInkler ther <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION <br /> Rcmovc/Repincc Gas Water Hcotcr <br /> PLUMBING MECHANICAL <br /> NO TYPE OF FIXTURE OR ITEM O TYPE OF FIXTURE ORI EM <br /> ------- WATER CLOSET _ ----- AIC-A/HANDLINO UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ ___ LAVATORY (WASH BASIN) <br /> SHOWER ------- HEAT PUMP <br /> - -- UNIT HEATERS <br /> KITCHEN SINK 6 DISPOSAL CLOTHES DRYER <br /> —_—__ DISHWASHER — RANGE HOOD <br /> LAUNDRY TRAY _ I WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK (SERVICE/BAILMOP/ETC.) EXHAUST FAN <br /> OTHER_ OTHER_______ <br /> I 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 GOVCRNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <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 REGUI-NTING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION 1S MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Signature of Owner/Contractor/Authorized Agent � w i67U dBP Date 01/302008 <br />