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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />-� <br />1310 MARYLAND AVE <br />00605502100001 <br />! LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DE C. <br />OWNER ADDRESS CiTYIZIP PHONE <br />FREDRIC MATHENY SAME AS SITE ADDRESSS F%�rett 98203 425-252-9533 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Cyndal/Naida 360-945-2787 <br />CONTRACTOR `A =SCO ADDRESS CITY21P PHONE <br />V V 2800 Thorndyke SEATTLE 800-398-4663 <br />CONTR. LICENSE # `^, ^ SHIES971 OB <br />1 LJ <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />residential I <br />_Electric V/—Gas_Other <br />950.00 <br />WORK DESCRIPTION <br />REPLACE GAS 50 GALLON HOT WATER HEATER <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />+ <br />Water heater <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes ova: her <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink(service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />_ <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boiler <br />_ <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodstove <br />_ <br />Roof drains <br />_ <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerdify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of vmrk will be complied with whether specified herein or not. 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 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 />State Contractors Law 18.27 RCW and 296200 WAC. <br />9/9/11 <br />Signature of OwneUContraclor/Authorized Agent Date <br />