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SITE ADDRESS <br />8502 9th Ave SE <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />Tim Tinsley <br />TENANT NAME <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 />00402500000500 <br />BLOCK I TRACT <br />8502 9th Ave SE <br />CONTACT FOR PERMIT <br />Naida Khan <br />T# <br />GI I Y/LIF' F'HUNt <br />Everett 9s208 425-355-7520 <br />CONTRACTOR HOIII@ D2pOt At HOf71@ S@fVIC2S ADDRESS CITY/ZIP <br />3600 Lind Ave Sw Suite 150 Renton <br />CONTR. LICENSE # HOMED**972RQ <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />HEAT SOURCE <br />Electric Gas Other <br />PHONE <br />360-945-2787 <br />PHONE <br />800-381-5699 <br />CONTRACT PRICE OF WORK <br />$18,190.00 <br />REPLACE 16 SQUARES OF COMPOSITE ROOFING; NO PLYWOOD REPLACEMENT AND <br />REPLACE 2 SKYLIGHTS; NO SIZE/STRUCTURAL CHANGES Everett business 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 />il� <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 296.200 WAC. <br />Kathleen Genge °'y"r"Y"9°`°�r"�„h'ee°`e�9` °� <br />DN.ci=1(othlecnGenqe,�NorlhwestPe�mitinc..o mail—kat'.unw{�erni�l.<um,c=l15 <br />U.��c� i01403.02 12�50�.4N �OB'00' <br />Signature of Owner/Contractor/Authorized Agent Date <br />