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Irnn: 06/P'/2007 10:36 0601 P. 003/004 <br /> PERMIT APPLICATION 369673 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425.257-8810 <br /> 425-257-8857 FAX <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 241 1 80 PL SE,EVERETT, WA 98203 00691100000700 I` <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC.OWNER ADDRESS PHONE <br /> MILLER, HARRY 1. 2411 80 P1L,SF (425)356-9950 <br /> EVERETF. WA 98203 (425)356.9950 <br /> TENANT NAME CONTACT NAME PHONE <br /> Pamela Hill 800.454-8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSU <br /> I.-AS'I WA'FERlll[A'IERCOMPANY 12601132NDAVENE FAS"FWW11948DC <br /> eHONE <br /> (425)814-3124 KIRKLAND, WA 98034 01/032008 <br /> _ <br /> PROPOSED USE OF BUILDING Bu1ldln0 �Mechani�Ca WORK Addition H AT SOURCE <br /> PERMIT Combinellon ®Ptumbin Alleradon Electric <br /> TYPE Demoll1lon Slpn TYPE New as <br /> Re alr/MelnlHch., <br /> CONTRACT PRICE OF WORK $449.00 CITY OF EVERETT LOCI'-SALES TAX CODE IS 7105 <br /> WORK DESCRIPTION <br /> Remove/Replace Gas Water I Icutcr <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE O ITEM TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER 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/BAR/MOP/ETC.) EXHAUST FAN <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 B' COMPLIED WIHT WHETHER SPECIFIED HEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUT HURITY 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 FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Signature of Owner/Contractor/Authorized Agent ��-� Y ��..- Dab 06.!072007 <br /> m�m <br />