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To. Pcrn-tIt �c�artrri�nt Pages 1��T 4 LOl�1-O�l-L'G OL�.55:53 (CMT) '18S£5�30003F13 Fic��i�. �eboral� St�le::l�1s <br />_ .— __"_. "_ — • _ . __.__ __ � <br />� <br />SITE ADDRESS <br />2115 74th St SE <br />LEGAL tOT NO. <br />DESC. <br />PERMIT APPLICAT�ON <br />CiTY OF EVERETT PERMIT SERVICES <br />32Q0 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 PNf <br />PARCEL TAX t.D. # <br />00545204102500 <br />BLOCK TRACT <br />PERMIT # <br />� i �G�� <br />OWNER ADDRESS CITY/ZIP PHONE <br />Daniel and Apryl Vrtis 2115 74th St SE Everett 98203 425-347-1981 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Naida Khan 360-945-2787 <br />CONTRACTOR H011l@ D@pOt At H0111@ S@I"VIC@S ADDRESS CITY/ZIP PHONE <br />140 County Line Rd, #101 PACIFIC 800-381-5699 <br />coNTR. ucer�se # HOM ED��972RQ <br />USE OF BUILDWG <br />SFR <br />WORK QESCRIPTION <br />HEAT SOURCE <br />_ Electric _ Gas _ Other <br />REPLACE 18.7 SQUARES OF COMPOSITE ROOFING <br />NO. I TYPE OF FEXTURE 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 />Urinai <br />Drinking Fountain <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />$9105.13 <br />HANICAL <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 ihe same to be true and correct. AI( 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 siate or local law regulating construction or the performance of <br />construction. That ! am authorized by the owner of this property to perform the work for which appiication is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />-� Digitally signed by Naida Khan <br />I�I a i rI a �� a ii DN: rn=Naida Khan, o=Northwest Permit Inc, ou, <br />nature of Owner/Contractor/Authorized An<�ntoace:zo�a.onzi �9sa:oa-oroo� <br />