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frttn: 09/06/2007 12:40 0782 P. 002/003 <br /> PERMIT APPLICATION 377418 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201. 425-257-8810 <br /> 425-257-8657 FAX q —q -V� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 170 61 PI.SE,EVERETT, WA 98203 (10764900002900 ' <br /> LEGAL LOT NO. BLOCK (TRACT <br /> OWNER [AD0DRESS PHONE <br /> BOYCE,LAMES 61 PI.SE (425)870.2662 <br /> ERETT,WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randall 800-454-8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> FAS I WATER 11EATER COMPANY 12601132ND AVE NE FAST%V W H948HC <br /> KIItKLAND, WA 98034 01/032008 <br /> _PHONE 800-454-8955 <br /> PROPOSED USE OF BUILDING Building • Mechanlce -WORK Addition H AT SOURCE <br /> PERMIT Combinallon Plumbing Alleration Elcchlc <br /> TYPE Demolition 81pn TYPE New as <br /> Sprinkler R• dr/Malnl her <br /> CONTRACT PRICE OF WORK 5449.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DFSCRIPTION RcnwvNltcplacc Gns \Vater Ilcatcr <br /> PLUMBING MECHANICAL <br /> NO I TYPE OF FIXTURE OR IIEM NO, TYPE E 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 & DISPOSAL CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY --�__ 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 (SERVICFJBAR/MOP/ETC.) EXHAUST FAN <br /> OTHER.--- ---- ------ OTHER-------------------- <br /> ---- ----- ---- <br /> -------------------------- <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 THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HERE( <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 I AM AUTHORIZED <br /> BY 1HE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br /> Signature of Owner/Contractor/Authorized Agent G,r...,�yj��i��a„,1�id'p Date OUi04/2007 <br /> u,.m <br />