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SITE AODRESS <br />5622 BEVERLY LN <br />lE6AL LOY NO. <br />JOAN MANLEY <br />TENANTNAME <br />PERMIT APPLICATION <br />CI7Y OF E�/ERETT PERMIT SERVIC�S <br />3700 CEDAR STREET, EVERETT, WA 90201 <br />425-257-881(1— FAX 425-257-9857 — www.everettwa.org <br />APPLICAT10N5 ARE ACCEpTED FROM 8 AM TO 4 PM �_ "�� `�D <br />PARCEL TAX I.�. N I PERMR �M <br />00471800000400 � ;� - � - , ` <br />DLOCK TRACT <br />AODRE53 CIiY21P PHONE <br />_ 5622 BEVERLY LN [verett s620� 425 355-1140 <br />CONTRACTOR 1n�ES�O <br />VV <br />CONTR. ucEN3E � W�� u I ES 97 � � g <br />� <br />USE OF BUILDING <br />SFR <br />wc:_• ��scRivnoN <br />CONTACT FOR PERMIT <br />Naida Khan <br />ADDRES9 <br />2800 Thorndyke <br />HEqTSOURCE <br />� Eleefric � Gas _ Olher <br />REPLACE 50 GALLON GAS WA7ER HEATER <br />N0. I iYPE OF FIXTURE OR I7EM <br />Bathtub <br />Levalury (wash basir� <br />6hower <br />Kitchen sink & disposal <br />Dishwasher <br />Clo!hoa wacher <br />Loundry tray <br />Sink (servlce/barlmop/etc ) <br />Betkflow prevr.ntrr <br />Urinal <br />Drinking Founfain <br />Fluor drein <br />Grease Irap <br />Roof drains <br />Other <br />PHONE <br />360-945-2787 <br />CITY?JP PHONE <br />SEATTLE 800-398-4863 <br />CUNTRACT PRICE OF WORK <br />$950.00 <br />N�• � TYPE OF FIX7URE OR ITEM <br />A/C — alr hantlling units <br />Forced air systers <br />Gas piping <br />Water hea�er <br />Gas fireplace <br />Gas ranpe <br />Gloches aryer <br />Range hoxl <br />Exhaust ten <br />lieet pump <br />Unit heater <br />Boiter <br />Retdgor�lion <br />Woodstove <br />Other <br />CITT OF EVERETI WCpL SALES TAX CODE IS J105 <br />i hereby ceritify that 1 heve read and exemined thls appiieation and know 1he same to be true and correct. All provisions of lews and <br />OrcJinaces poverninp this type ef wnrk will be compfed with whather epedficd heroin or aot. The qronNng of a pemiil ducs nvl y�esume <br />to give authoriiy to violate or cancel the provision of any other state or loce� law regulatinp consWdlon or the peRormance of <br />constn,ction. Tha� 1 am authorized by lh wner of this property to perlortn the o�C for which application la mada and I mmply with the <br />Stale Contraaors Law 18.27 RCW �n/d� 9 �7� <br />_ I ,/ ( l l\��-�+'�`� � <br />