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From: 10;'Of �?01i 09:25 �786 P.002I002 <br /> t <br /> PERMIT APPLICATION 55",Z <br /> ���� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> 425-257-8857 FAX ro/�4 �II <br /> SITE ADDRESS PARCEL TAX I.D.If ''A PERMIT# <br /> 1001 W CASINO Rl)H}{306,GVERIiI'1', WA 98204 00431000000400 � I l l b ' �y.�/_ <br /> WU/ <br /> LEGAL LOT NO. BLOCK 7RACT <br /> OWNER AODRESS PHONE <br /> HAD%IC, BSED 1001 W CASINO RI)qH30G (425)773-I090 <br /> � EVERETI',WA 982U4 <br /> TENANT NAME CONTACT NA E PHONE <br /> ���e aS 425-636-70 <br /> CONTRACTOR ADDRESS CONTR.LICENSEA� <br /> FASTWA"CI:RHF:A7'GRCOMPANY 1260I 132NDAV�NG FASTWW11948f3C <br /> I:IRKLAND, WA 980J4 01/04/2012 <br /> 425-63d-70�/ <br /> PROPOSED USE OF BUILDIN(3 ew�e�np M�ch�n�ca WORK Adetuon H T SOURCE <br /> PERMIT Combin�llon Plumbinp .. Nl�ntlo� ENctric <br /> Residential TypE D�moliUon s�o� TMPE N�w as <br /> R� �IrlMalnl har <br /> CaNTRACT PRICE Of WORK � CITY OF EVERETT LOCAL SALES TAX CODEIS J105 <br /> WORK DESCRIPTION Kemove/Reploce Eleclric Watcr Ilcater <br /> PLUMBIN6 MECHANICAL <br /> O I TYPE OF FU(TURE OR ITEM <br /> ___ WATER CLOSET _______ A/C•A/HANOLIN6 UNITS <br /> � BATMTUB __��_ FORCED AIR SYSTEMS <br /> __ LAVATORY(WASH BASIN) __�_ HEAT PUMP <br /> � SHOWER ___ UNIT MEATERS <br /> �_ KITCHEN SINK 6 DISPOSAL ___ CLOTHES DRYER <br /> � DISHWASHER _ _ RANGE HOOD <br /> ___ IAUNDRV TRAY _,�_ WATER HEATER <br /> �_ CLOTHES WASMER _�__ METAL FIREPLACEfSTOVE <br /> ____ URINAL ___ FIREPLACE INSERT <br /> _ ORINKIN6 FOUNTAIN _ pA8 fIREPUICE <br /> FLOOR DRAIN _ GAS RAN6E <br /> ___ BACKFLOW PREVENTER _� 6AS PIPINO <br /> � SINK (SERVICE/BAR/MOPIETC.) _^_ El(HAUST fAN <br /> _�_ OTHER _^_ OTHER________��_________ <br /> I HEREBY CERTIFY THAT I MAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS ANU ORDINANCES GOVERNING THIS 1YPE OF WORK WILL BE COMPLIEO WIHT WMETHER SPEClFIED HtREI <br /> OR NOT.THE ORANTING OF A PERMIT DOES NOT PRESUME TO ONE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL UW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT I AMAUTHORIZED <br /> DY TNE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITM TME STATE <br /> CONTftACTORS LAW 78.27 RCW AND 298.20D WAC. <br /> Sipnalure of Owner/Contnetor/Authoriz�d Agent � ���� �0/04201 I <br /> �f�yl� <br />