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SITE ADDRESS <br />5719 Sound Ave <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />00731700000200 <br />BLOCK TRACT <br />ERMIT # <br />CITYIZIP PHONE <br />Roberta McGillivray 5719 Sound Ave Everett 98203 425-290-9317 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Naida Khan 360-945-2787 <br />coNTRacroR Home Depot At Home Services ADDRESS cirYiziP PHONE <br />3600 Lind Ave SW Ste 150 Renton 98057 800-381-5699 <br />CONTR. LICENSE# HOMED**972RQ <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />HEAT SOURCE <br />_ Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />$1875.74 <br />Replace 3.66 squares of composite roofing. No plywood replacement Everett business <br />license # 042478 <br />NO <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 295.200 WAC. <br />Kathleen Genge o,9�„���,��g��d,,YK,�n��..,,�,.�9�. <br />DN'. � �� Ka�hlceii Genqc, <�- Nu�lliwi�s� Pi•����il I�ic., ou, ��i�i.iil � k�tw�iiwUi��ni�il coin, c=US <br />�rlc'. 3015-05.f13 19�.1H:34 -0]'00' <br />Signature of Owner/Contractor/Authorized Agent Date <br />