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PERMIT APf'LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettv✓a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />5709 HIGHLAND RD <br />LEGAI �_O'i NO. BLOCK <br />DESC <br />DARREN 3� MARY POPKINS <br />PARCEL TAX I.D. # <br />ooa�ia00002soo <br />TRACT <br />5709 HIGHLAND RD <br />PERMIT # <br />� �2i1�o52__ <br />Everett 982� I 425-290-8867 <br />TENANT NAME CONTACT FOR PERMIT PliONE <br />_�A�����1� Jen.�ifer Burgess 206-774-9499 <br />CONTRACTOR `A'C.�+�_ ADDRESS pTYIZIP PHONE <br />VVGJ 3909 196 St SW, Lynnwood 98036 800-398-4663 <br />CONTR.LICENSEN�A�ASHIES9! �OB <br />1IV <br />USE OF BUILDING <br />Residential <br />WORK DESCRIPTION <br />REPLACE 60K GAS FURNACE <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basln) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes � .,.sher <br />Laundry tray <br />Sink (service/barlmop/etc.) <br />Bachllow preventer <br />Urinal <br />Drinking Fo�!�dain <br />Floor dr, in <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Electric y� Gas _ Other <br />CONTRACT PRICE OF WOKK <br />4257.40 <br />NO. I TYPE OF FIXTURE OR IEM <br />---+--- — <br />A/l, = au handling units <br />� Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />qothes dryer <br />Range ho ) <br />Exhaustian <br />Heat pump <br />Unit heater <br />Boiler <br />Relrigera6:,n <br />Waodstwe <br />Olher <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritify that I have read and examined this application and hnow the same lo be true and correct. All provisions ot laws and <br />ordinaces goverm:�g this type of work will be complied Hath whether specified herein er noL The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulahng construction or the pertormance of <br />constructlon. That I am authorized by the owner of this pwperty to pertorm the Hvrh for which application is made and I comply with the <br />State Contractors Law 1827 RCW antl 296 200 WAC <br />C��LdI� 4qmv: W lmn�ln lfaqnt <br />Jenniter Buraess ;�;���,�;�,,,:r,�;,;�����;nm��°..tmr,�_.�,.:��i�o�aa�� <br />