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PERMIT APPLICATION <br />CITY OF EVERET'T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — w%%w.everettwa.org <br />G <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. N <br />P RMIT# <br />3422 HOYT AVE <br />00436982402000 <br />0703 -03g <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITYMP PHONE <br />KARENHENDRICKS 3422HOYTAVE Everett90201 425-259-6423 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Naida Khan 360-945-2787 <br />iCONTRACTOR , ESCO ADDRESS CITYINP PHONE <br />VV <br />CC t2800 Thorndyke SEATTLE 800-398-4463 <br />CONTR. LICENSE a WASHIES97106 <br />_ <br />USE OF BUILDING HEAT/SOURCE CONTRACT PRICE OF WORK <br />S FR _ Electric 1 Gas_ Other 750.00 <br />WORK DESCRIPTION <br />Replace gas to gas 40 gallon 40,000 b`.0 water heater <br />F UMBINO <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NC- air handling units <br />_ <br />Toilet <br />_ <br />Bathtub <br />— <br />i <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Show r <br />i <br />Water heater <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />- <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />Sink (service/bar/mop/etc) <br />Exhaust fan <br />Rackflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and tarred. All provisions of laws and <br />ordlnacrn govaming this type of work will bo complied with whether opecified heroin ar not, The granting Vf a pemtlt does not presume <br />to give authority to violate or cancel the prevision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application Is made and I comply with the <br />Slate Contractorss Law 18 - RRCW and 2g8 70n WAG. <br />Blgnature of OwnerlCrictor/Author zed Agent 53te It I <br />