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Frnn: 02/11/2009 11:47 p232 P.002/002 <br /> PERMIT APPLICATION �33298 <br /> l,�i� CITY OF EVERETT PERMIT SERVICES <br /> F 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 p <br /> 425-257-8857 FAX � �I� -0 ` <br /> SITE ADDRESS PAFiCEL TAX I.D.# PERMIT� <br /> 820"�CADY RD d1306,GVERIiTC, WA 98203 00193200930G00 � - . <br /> � l.x ' � � - �_j� . <br /> LEGAL LOT NO. BLOCK TRACT <br /> D <br /> OWNER ADDRE3S PHONE <br /> 620 G CADY RD dJ306 <br /> STRAND, KGRRti' (425}4?2•8611 <br /> • P.VI;RETI', 1VA 9R203 <br /> TENANTNAME CONTACTNAME PHONE <br /> Carol Randall 425-636-7054 <br /> CONTRACTOR ADDRESS CONTR.LICENSEA� <br /> FAS�I' 11'A"fGli IIEATHR COAIPAK�Y 12G01 132ND AV}3 Ng FAST1b'W11948[3C <br /> 425-636-7054 KIRRLAND, WA 9R034 OIi04/2(110 <br /> PROPOSED USE OF BUILDING ewm�no M�ah�nlos Addl�lon H AT SOURCE <br /> PERMIT Combin�llon ' Plumbinp WORK N��ntlon Elactrte <br /> 7YPE Damollllon 91pn TYPE N�w �Oas <br /> R� �IrlMalnl Uther <br /> CONTRACT PRICE OF WORK S3A9.00 CITY OF EVERETT LOCAL SALES TAl(CODEIS 7105 <br /> WORK DESCRIPTION �t�move/Replacc Glectric Watcr Hcater <br /> PLUMBING �::HANICAL <br /> NO. TYAE OF TU I EM � O T E OF IXTURE OR ITEM <br /> _______ WATER CLOSET ______ AIC-A/HANOLING UNITS <br /> ____ BATHTUB �_____ FORCED AIR SYSTEMS <br /> ____ LAVATORY (WASH BASIN) _____ HEAT PUMP <br /> ___� SNOWER ,____ UNIT HEATERS <br /> ___ KITCHEN SINK 8 OISPOSAL __�__ CLOTHES DRYER <br /> _�_ DISHWASHER _ _ RANGE HOOD <br /> ___ LAUNDRYTRAY ___1__ WATER HEATER <br /> �_ CLOTHES WASHER ,�_ METAL FIREPLACE/STOVE <br /> _� URINAL ____ FIREPLACE INSERT <br /> DRINKING FOUNTAIN OAS FIREPLACE <br /> ,, FLOOR DRAIN , ,_ GA9 RANOE <br /> _�_ BACKFLOW PREVEN7'ER _� GAS PIPIN� <br /> ___ SINK (9ERVICE/BAR/MOPJETC.) ___ EXHAU3T FAN <br /> ��_ OTHER�� _ __ _ OTHER________________ <br /> 1 HERE[7Y CERTIFV THAT I MAVE READ AND E?tAMINED T?i15 APUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PFiOV1510NS OF LAW$ANU OR7INANCES GOV[RNING TFiIS TYPE OF WORK WILL BE COMPLIED WINT WMETHER SPECIFIED MEREI <br /> OR NOT. THE GRANTING OF A PGRMIT DUES NOT PRESUME TO OIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISqN OF ANY <br /> 07HER STATE OF LOCA�lAW REGULATING CONSTRUCTION pR THE PEftFORM/WCE OF CONSTRUCTION.TMATI AMAUTMORIZED <br /> BV THE OWNER OF TNIS PROPERTY TO PERFORM THL WORK FOR WHICII A7PLICATION IS MADE AND I COMPLY WITH TME STATE <br /> CONTRACTORS 1 AW 182/RCW AND 298.20D WAC. <br /> Slpnaturo of OwnodGontnttorlAuthorized Apenl �yy,���y71��?�,,,�t�'P ���� p�/��na09 <br /> J <br /> ui w� <br />