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,- F .:RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />_ 3200 CEDAR STREET, EVERETT, WA 982C1, 425-257-8810 <br />CK 1150 <br />SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br />2421SI ITSF.,EVERETT. WA 98203 00691100004100 I/`Dj0t-003 <br />LEGAL LOT NO. BLOCK TRACT <br />OWNER ADDC. <br />RESS PHONE <br />THOSIAS• PATRICIA 2421 S I PL SE <br />_ 1A.'ERETT.IVA 98203 (425)290.6932 <br />TENANT NAME CONTACT NAME PHONE <br />PAMELA HILL 425 814-3124 x133 <br />CONTRACTOR <br />_ <br />ADDRESS <br />CONTR.LICENSE# <br />FAST WATER IIFATER COMPANY <br />12601 132ND AVE NE: <br />FASTWHC05210 <br />ptjONE 1425)K14.3124 <br />KIRKI.AND. WA 98034 <br />02/16/2005 <br />PROPOSED USE OF BUILDING Bulldlnp Mechenice lon HAT SOURCE <br />PERMIT Comulnellon Plumbinp WORKedon Electric <br />TYPE Demolition Sign TYPE ie <br />URRepairMaint <br />r trier <br />CONTRACT PRICE OF WORK 54.19 nn CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION <br />Rcnunc Rcpla:c Ga, Water Ilcatcr <br />PLUMBINQ MECHANICAL <br />NO. I TYPEOF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET A/C-A/HANDLING UNITS <br />__ <br />BATHTUB FORCED AIR SYSTEMS <br />-------- LAVATORY (WASH BASIN) HEAT PUMP <br />SHOWER _ UNIT HEATERS <br />KITCHEN SINK 6 DISPOSAL CLOTHES DRYER <br />_ <br />DISHWASHER RANGE HOOD <br />LAUNDRY TRAY _ I WATER HEATER <br />CLOTHES WASHER __ METAL FIREPLACEISTOVE <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 EXAM—ED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BF C:JMPLIEO 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 REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATI!. i IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Signaluro of Owner/Contractor/Authorized Agern ��JLQ Date <br />12/30/2003 <br />u wi <br />