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From <br />0710"2011 12:13 #700 P.0031003 <br />PERMIT APPLICATION 547937 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />425-257-8857 FAX 7. `] (( <br />SITE ADDRESS <br />PARCEL TAX I.D.# <br />PERMIT# <br />620 90 ST SW, EVERLTT, WA 99204 <br />00699400001204 <br />I I q <br />LEGAL LOT NO. BLOCK TRACT <br />OWNER ADDRESS PHONE <br />62090 STSW (425)478-6322 <br />I'hRRLT, JAN <br />EVERETT, WA 99204 <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />ie <br />475636-70gq <br />CONTRACTOR <br />ADDRESS <br />CONTR.LICENSE# <br />FAST WATER HEATER COMPANY <br />12601 132ND AVE NE <br />I:AS•rWWII948BC <br />PHONE 425-636-70gN <br />KIRKLAND, WA 99034 <br />01/04/2012 <br />PROPOSED USE OF BUILDING <br />PERMIT <br />Building Machanica <br />Combination Plumbin <br />WORK <br />ion <br />rtlon <br />HEAT SOURCE <br />Electric <br />Residential <br />TYPE <br />Demolition Slgn <br />TYPE <br />NAjdj6da <br />Now <br />Loos <br />Re drlMaInl <br />Cher <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK BE Rcmovc/Keplace Gas Water Healer <br />PLUMBING <br />MECHANICAL <br />O. I TYPE OF FIXTURE OR ITEM <br />O TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />_______ <br />A/C-AIHANDLING UNITS <br />BATHTUB <br />__—__ <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />____-_ <br />HEAT PUMP <br />SHOWER <br />—__ <br />UNIT HEATERS <br />_ <br />KITCHEN SINK 6 DISPOSAL <br />CLOTHES DRYER <br />DISHWASHER <br />__ _ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />___ <br />METAL FIREPLACE/STOVE <br />URINAL <br />______ <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />_—__ <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />___ <br />GAS RANGE <br />BACKFLOW PREVENTER <br />__ <br />GAS PIPING <br />- <br />SINK (SERVICE/BAR/MOP/ETC.) <br />___ <br />EXHAUST FAN <br />--- <br />OTHER <br />----- <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 BE COMPLIED WIHT WHETHER SPECIFIED HEREIN <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 CONSTRUCI ION. 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 296.20D WAC. <br />Slpneturs of Owner/Contractor/Authorized Agent vk I Date 07/0721111 <br />