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PERMIT APPLICATfOP� � <br /> CITY OF EVERETT F'�RM�T SERa/ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8310— FAX 425-257-8857—wvw�.everettvda.org <br /> APP�ICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM <br /> SITE ADDRESS PARCEL TAX I.D.# � PERMIT # <br /> 1034 LANE PL UNIT A ooa029oo003200 � M 13oq - 03� <br /> LECY'�'. LOi NO. BLOCK TRACT <br /> DESC r <br /> OWNER AODRESS qTY/ZIP PHONE <br /> DAVID G HUDSON 1034 LANE PL UNIT A Everel�98203 425-508-8951 <br /> TENiVJT NAh1E GONTACT FOR PERMIT PHONE <br /> Naida Khan 360-945-2787 <br /> CONTRACTOR �,A/�SCO ADDRE55 qNlZIP PHONE <br /> VY 3909 196th Si SW Lynnwood 800-398-4663 <br /> CONTR. LICEtJ:iE u WAS H I�S971 OB <br /> USE OF BUILDING HEAT SCURCE CONTRACT PRICE OF WORFC <br /> I'@SI�BIltlB� _Eiectric �Gas_Jtrer �']50 <br /> WORH DESCRiPTION <br /> REPU�CE GAS WATER HEATER. <br /> PLUMBING MECHANICAL <br /> NO. IYPE OF FIXTURE OR ITEhi N0. TYPE OF FIXTURE OR ITEIn <br /> i oilet A/C —air handling unds <br /> BatMub Forcetl air systems <br /> � Lavatory (wash basin) _ Gas riping <br /> Shower _, Wa[erheatcr <br /> Kitchen sm:.& di=;ccal Gas hreplace <br /> Dish��asher Gas range <br /> Clothes washer Clo'hes tlryer <br /> _ Laundry tray Ranoe hood <br /> _ Sinh (s?rv�ce/bar/Top/etc.) Ezhaustfan <br /> � 6ackllowpreventer _ Heatpump I <br /> Unnal Unrt heater <br /> _ Dnnking Fountain Boder <br /> Floor drain Refngeretion � <br /> Grease trap Woodstwe <br /> Rool drains Other <br /> Other <br /> CIiV OF EVERET7 LOCAL SALES TAX CODE IS 3705 <br /> i h.reby cenUty tl�at I have read and er;amined this appli[ation anU know the same to be true and COrrect. All prwi5ions of laws and <br /> ord��naces governing ihis type of worh�.viu be complietl wrth whether specilied herein or not The granting of a permit ooes not presume <br /> to grve authonty lo vioiate or cancel[he provision of any other state or local law regulating mnstruction or the pedormance of <br /> tonshuction Th�t I am aulhon_ed by the ov:ner of ihis property to perlorm the v.nrk for whKh apolication is made and I comply�vrth Ne <br /> State Contractors Law�8 27 RCW antl 296?00 N/AC. I <br /> Cagqailr+Jned bY��mda i han <br /> N a i d a Kh�u�a1=J 1!lN�dn O lip�ihrv[5:`MTi� <br /> rielilmaJet��+C�'�R'i:(nn.t'V$ <br /> S�onature ot OwneuContractodAUUion_eJ Ac�JNnt����'"���va����s���=��'�'�° Date <br />