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frnn: 10/3n/2007 13:37 #110 P.003/003 <br />PERMIT <br />APPLICATION 383221 <br />CITY OF EVERETT PERMIT SERVICES <br />4,-7rr <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX <br />SITE ADDRESS <br />PARCEL TAX I.D.# <br />PERMIT# <br />702 90 PL SE, EVERETT, WA 98208 <br />00605900000100 <br />1\1 u -] I b - C)�) 1i <br />6 <br />LEGAL <br />L01'NO. <br />BLOCK TRACT <br />OWNER <br />ADDRESS <br />PHONE <br />LARSON, Cl1RT15 <br />702 90 Pi, SE <br />(725)355-0437 <br />yEItETT, WA 98208 <br />• EPHONE <br />TENANT NAME <br />CONTACTNAME <br />PHONE <br />Carol Randall <br />800-454-8955 x 133 <br />CONTRACTOR <br />ADDRESS <br />CONTR.LICENSE# <br />PASTWA'I'ERHBA'I'ERCOMPANY <br />126G1132NUAVENE <br />FASTWW11948RC <br />1`IRICLANU, WA 98034 <br />01/03/2008 <br />800-454.8955 <br />PROPOSED USE OF BUILDING <br />PERMIT <br />Dulldlnp MaehaniCa <br />WORK <br />Addition <br />HEAT SOURCE <br />Combination Plumhln <br />Altaratlon <br />Elaetrle <br />TYPE <br />Damolitlon Sign <br />TYPE <br />New <br />as <br />Ra alr/Malnl <br />her <br />CONTRACT PRICE OF WORK $349.00 <br />CITY OF EVERETT <br />LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION Rcmovc/Rcpincc Electric Water Ilcalcr <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. I TYPE O X UP OR ITEM <br />WATER CLOSET <br />A/C•A/HANDLINO UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />_ <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 6 DISPOSAL <br />CLOTHES DRYER <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />_ <br />OAS FIREPLACE <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />GAS RANGE <br />OAS PIPING <br />_ <br />SINK (9ERVICElBARIMOPIETC.) <br />_ <br />EXHAUSTFAN <br />OTHER <br />OTHER—_y___,_______ <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 GOVERNING TF115 TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREIN <br />OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AMAUTHORIZED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 16.27 RCW AND 200.200 WAC. <br />Slgnpluro of Owner/Contractor/Authorized Agant Date 10/30/2007 <br />