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To: City of Everett Page 2 of 3 2014-12-16 02:47:50 (GMT) 18884000383 From: Deborah Shields <br />StTE ADDRESS <br />608 92nd St SE <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />George Haage <br />TENANT NAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982(i1 <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 />00534200000200 <br />BLOCK I TRACT <br />608 92nd St SE <br />CONTACT FOR PERMIT <br />Naida Khan <br />CITY/ZIP <br />Everett 9820 <br />PERMtT # <br />�i�i2- Di� <br />PHONE <br />� (425) 353-8289 <br />PHOIVE <br />360-945-2787 <br />CONTRACTOR HOI71B D@POt At H011l@ S@fVIC@S ADDRESS CITY/21P PHONE <br />140 County Line Rd, #101 PACIFIC 800-381-5699 <br />CONTR.IlCENSE# uOMED**972RQ <br />I-1 <br />USE OF BUiLDtNG <br />SFR <br />WORK �ESCRIPTION <br />HEAT SOtlRCE <br />_ Electric � Gas _ Other <br />CONTi2ACT PRICE OF WOi2K <br />$20, 992.16 <br />REPLACE 24 SQUARES OF COMPOSITE ROOFING; REPLACE 4 SHEETS PLYWOOD <br />EVERETT CITY BUSINESS LICENCE 042478 <br />� <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 />Urinaf <br />�rinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />MEC <br />NO. � 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 />Boi€er <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 wilE 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 faw reguiating construction or the performance of <br />construction. That t am authorized by the ow!ntnenr of this property to perform the work for which application is made and i compiy with the <br />S�C.1 `1 Itrl�e e na V� I 1 t.1 e and 2.�J_�1�W/���vKatnleenGenge <br />�-. UN:cn-K5[hleeriGrnge,D_NJtNwestPern�itlnc.ou, <br />�ail-katt-nwpermi[.coni. c-VS <br />� . Date�,t011.12.1518'39'.27�U80G' <br />Signature of Owner/Contractor/Authorized Agent Date <br />