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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everattwa.org <br />�I — Z Z--Ud7 <br />� U�� _c�y.� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREIiIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # I�RM�U�� �/ <br />...... ..... ..-----.. ....�� ....... �une�enn � n � snn I � 0 � <br />LOT NO. <br />DESC. <br />TRACT <br />Hwangpo Jeong H S Hyeon Mi 12011 NE 100th St ltirkland, WA 98033 <br />TENANTNAME CONTACTFORPERMIT PHONE <br />�� ^Q� ;;a;;,;:. I Steven Thomson 425-917-2109 <br />CONTRACTOR �RSIgII�B SI�II II1C. ADDRESS CITY2IP PHONE <br />2109 <br />CONTR. LICENSE # ��SIGSIOB�.OZ <br />USE OF BUILDING <br />PO BOX 2849 <br />HEpTSOURCE <br />Electric Gas Other <br />Renton, WA 4ZS-917- <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />Remove exlsting GasCo signage S repla�e with new Oasls Image 76 signaga. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />;lothes washer <br />Laundry tray <br />Sink (service/bar/mop/etcJ <br />Backflow prevenler <br />lrina I <br />)rinki ng Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />;lothes dryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Jnit heater <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETf LOCAL SALES SAX CODE IS 3105 <br />I hereby ceritify thal 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 lype 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 o( any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property tu pedorm the work for which application is made and I comply wilh the <br />State Contractors Law 18.27 RC�'v and 2�J6.200 WAC. <br />`�z <br />