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[�8-1�7-'05 19: �Ft FRui1-nw prrmit 136�9952A91 T-504 P004/�19 F-551 <br /> PERMIT APPLI�CATION � <br /> CITY OF EVERETT FERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—wvnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM g —/0 —�� <br /> SITE ADDRESS PARCEL.TAX I.D.7! PERMIT N �y <br /> 4009 KROMER AVE Ooa019oo0020o i�� JQ�'O <br /> LEGAL LOT NO. [3LOCK TRACT <br /> DESC <br /> OWNcR AODRESS CITYIZIP PHONE <br /> JUDY MUEN�H 4009 KROMER AV[ Everettse2ot 425-'L38-32£39 <br /> TENANT NA�d6 CCNTA�T FOR PERMIT VHONE <br /> Naida Khan 360-�945-2787 <br /> CGNTF2ACTOR �/�/ESUO aODRESS CITV/ZIP PHON9 <br /> V V 2g00 Thorndyke SEATTLE 600-398-4663 <br /> �o"T�."°E"SE"WAS H I ES971 OB <br /> USC-OF BUILDING HEAT SOURCE CONTRACT PRIC'_OF WORK <br /> S FR _E�actric �Gas_omcr 12560.00 <br /> WORK DGSCRIPTION <br /> REPLACE 90K BTU GAS FllRNACE; INSTALL 3 TrJN HEAT PUMP <br /> PLUMBINr MtCHANICAL <br /> Np, TVPE OF FIXTURE OR ITEM NO. TYPE OF FI%7URE OR ITEM <br /> Toilel A/C—air handling u�its <br /> � nalhWh � Forced air syslems <br /> Lavatory(wash basin) �os P�Ping ' <br /> Shower � Watar heater <br /> Kitchen sink&Aisposal Gas fireplece <br /> Dishwashe� � Gas range <br /> Gulhos washer Clolhes dryer <br /> Laundry tray _ Range hoad <br /> 3ink(sorvicelbadmopletc) E�ausl fan <br /> 9ackllnwprevenler + Heatpump <br /> Urinal UNt heater <br /> Dr�nkmg Fountain _ Boil:+r <br /> Floor drain Refric�eration <br /> Grea�e trap Woodstove <br /> Roof dra�ns O�her <br /> 011ier <br /> C�T'OF EVERETT LOCAL SALES TAX CO�G IS 3105 <br /> I hereby ceribty that i have read and examined Ihis appiication and know the same to De t;ue and correct. All provisions of laws and <br /> ordinaces governinc��hic rypa ol work will be compiied�dth whethar specified herein or not The granting of a permit does nct presume <br /> '� to give author�ty in vioiate or ca� ;el the prevision o�any other slste or local law regula6ng wnstruction or the pertormanca of <br /> Iconstructioa That I am 6ulhnrized 6y the owner o!�his property to perform lhe work for�SfiiCh BppliC2tion is matle and I comply With!he I <br /> I S�ala Goniractors Law 1827 RCW and 2�J6 2C0 WAC. <br /> � �i <br /> /� l <br /> Sipn•� �sr3vmer/Gontr���zed AQent � <br />