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P�RMIT APPLICATION `��� �.r:�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 �/ Q�p C� <br /> 425-257-8810—FAX 425-257-8857—www.evereriwa.org �d 9 p 3 ..pb 3 <br /> APPLICATIONS ARt ACCEPTED FROM 8 AM TO 4 PM - DEBIT &CREDIT C/1RDS ARE NOT ACCEPTEU <br /> SITE ADDRESS PARCEL TAX I.D.# PERM�?i y�� <br /> � ��� '��C.[/ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADURESS CITY2IP PHONE <br /> Dennis S Candice Matheson l3�eZ5 Pu�et Sound Blvd Edmonds WA 98026 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> rtie......, r_�� e.�t:�., Steven Thomsan 425-917-2109 <br /> CONTRACTOR IIISIgR�1 S�gR IRC. ADDRESS CITY2IP PHONE <br /> CONTR.LICEN5E# <br /> INSIGSI062QZ p0 BOX 2849 Renton, !NA 425-917-2109 <br /> USE OF BUILDING HEAT SOURCE C6NTRACT PRICE OF WORK <br /> Chavrnn Gas S�afi�p I _Electric _Gas_Other s►•ZS��.�� <br /> WORK DESCRIPTION <br /> Remove exlsting Chevron signage S replace with new Chevron Dmag� Refresh <br /> signage. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C—air handling units <br /> Balhtub _ Forced air systems <br /> Lavatory(wash basin) __ Gas piping <br /> Shower _ Water healer <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer _Clothes dryer <br /> — �, y Ran e hood <br /> S nk(serv ce/badmop/etc.) _ Exhaust fan <br /> Backtlow preventer _ Heat pump <br /> Urina I _Unit heater <br /> _Drinki ng Fountain _Boiler <br /> Floor drain _ Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains _ Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br /> I hereby c�ritify that I have read and examined this application and know the same to be true and corcect. All provisions of laws and <br /> ordinaces goveming this type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> to give authority t violate or cancel ihe provisiun of any other state or local law regulating construclion or the performance of <br /> consl 9lion.Tha I am aulhorized by the owner of this property lo perform;he work for which appli:atior is:na�ia and I comply with the <br /> Slate ontractors ew 18.27 RCW and 296.200 WAC. <br /> / r• � lNu^G1r ( <br /> Signature oP0 v�et/Contractor/Aulh ' e Agent Dale l/ <br /> � � <br />