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.,. <br /> Frnm; 12/1F�2008 13:42 q307 P.002/002 <br /> PERMIT APPLICATION 425�99 <br /> CITY OF EVERETT PERMIT SERVICES <br /> .._ 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> _ 425-257-8857 FAX �,z ��,5 —�J8 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITtt <br /> R20 E CAUY RD IJC-201, GVGRGTT, N'A 98203 00693200720100 V(� . ,G I.� � / <br /> � V\ll> �- �:� � <br /> LEGAL LOT NO. BLOCK ITRACT <br /> D� i�_— <br /> OWNER ADDRESS PHONE <br /> 820 G CADY RD NCi-201 <br /> HORTON, WILI.iS (425)239•3729 <br /> • I;VGFiETT, WA 98203 <br /> TENANT NAME CONTACT NAME PHONE <br /> Carol Randell R00-454•8955 x 133 <br /> CONTRACTOR ADDRESS CONTR.LICENSEp <br /> PAST WATfR HIiA'I'IiR COMPANY 12601 132ND AVC-.NF; pqyrW�y�19480C <br /> B00-454-8955 KIRI:LAND, WA 98034 01/04l2010 <br /> PROPO5ED USE OF BUILDING euudinp M.on.�i�a WORK Aeduion H T souRCE <br /> PERMIT CamLln■Iion ' plumhlnp Nt�nUon I�clrlc <br /> TYpE Damolillon � Blpn TMPE Naw aa <br /> r R� NrlM�lnt <br /> CONTRACT PRICE OF WORK S349.00 CITY OF EVERETT LOCAL SALES TAl(COOEIS �105 <br /> WORK DESCRIPTIDN Removc/Rcpincc Iilcctric Wetcr Ilcatrr <br /> PLUMBING MECHANICAL <br /> OF � URE O E O T URE O E <br /> ____ WATER CLOSET ______ A1C-AIHANOLING 11NITS <br /> ____ BATHTU6 ______ FORCED AIR SYSTEMS <br /> _______ LAVATORY(WASH BASiN) _�,_ HEAT pUMP <br /> _______ SHOWER UNIT HEATERS <br /> —_____ Y.ITCHEN SINK 8 OISPOSAL __ CLO?NES DRYER <br /> _____ DISHWASHER __ _ RANGE HOOD <br /> ______ LAUNDRY TRAY ___I__ WATER HEATER <br /> ______ CLOTHES WASHER ___ METAL FIREPLACEISTOVE <br /> ___ URINAL ____ FIREPLACE INSERT <br /> _�__ DRINKING FOUNTAIN ____ pA9 FIREPLACE <br /> _�__ FLOOR DRAIN �__ GAS RAN�E <br /> __�__ BACKFLOW PREVENTER __ OAS PIPINO <br /> _____ SINK (SERVICE/BAR/MOP/ETC.) ,_._ EXHAU97 FAN <br /> _____ OTHER OTHER____ <br /> I MEREBY CERTIFY THAT I MAVE READ AND E%AMINEO THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND OROINANCES GOV[RNING THIS TVPE OF WORK WILL BE COMPLIEO WIHT WMETHER SPECIfIED M[REI <br /> OR N07,THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIV[AUTHORITV TO VIOLATE OR CANCEI THE PROVISION OF ANV <br /> OTHER STATE OR�OCAL lAW REGULATING CONSTRUCTION OR 1ME PERFORMlWCE OF CONSTRUCTION.TMAT 1 AM AVTHORIZED <br /> BY THE OWNCR OF THIS PROPERTY TO PERPORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW t 8.77 HCW ANO 439700 WAC. <br /> Signaluro of OwnedContractorlAuthorltod Apent �y��yy.7�����p Dats 1z��5/2006 <br /> / u�.ni <br />