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SITE ADDRESS <br />3605 ROCI <br />LEGAI LOTNO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />31UU CEUAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />BLOCK <br />ROWENA VANGENDEEN <br />TENANTNAME <br />� CONTRACTOIt W�c�+O <br />O <br />CONTR. LICENSE � WAS H I ES971 OB <br />USE OF BUILDING <br />SFR <br />�, WORK DESCRIPTION <br />PARCEI TAX I,O. tf <br />� 00438188200300 <br />TRACT <br />PERMIT# <br />3605 ROCKFELLER AVE Everett se2ot 425-259-4509 <br />�CONTAGTFORPERMIT PHONE <br />Naida Khan 3b0-945-2787 <br />AODRESS CITY2IP PHONE <br />2800 Thqrndyke SEAT'TLE 206-378-6649 <br />Replace gas to gas 40 gallon weter heatcr <br />NO. I NPE OF FiXTURE OR ITEM <br />Toilet <br />� �alhtu6 <br />� Lavatory (wach bacin) <br />Chn�nror <br />Kltchen sink 8 tlisposal <br />Dishwa<hn.r <br />Clothes washer <br />Laundry trdy <br />Sink (servicelhar/mop/etc.) <br />Backtlow preventer <br />� Urinal <br />Drinking Foun;ain <br />FIOOr drain <br />Grease Vap <br />Root drains <br />— omer <br />HEATSOURCE <br />Electric �Gas_Other <br />N0. <br />CONTRACT PRICE OF WORK <br />750.00 <br />MECHANICAL <br />TYPE OF FIXNRE OR ITEM <br />AIC — air hantl�ing units <br />Forced air systems <br />Ca� piping <br />Walar heate[ <br />Gas firepla:e <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heatet <br />Boiler <br />Rertigeration <br />Woodstove <br />Olher <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 7tos <br />I hereby ceritify that I have read and examined this application and know the same to be ttue and wrtect. All provisions of laws and <br />ordinaces goveming this type of work will be Complied with whether spedfied herein or not. The oranting ot a pertnrt oces no[ presume <br />to give authonty to vioiate or cancel the provision of any other state or local law reguleting construc,ion or the pertormance oF <br />construciion. That I am authori.ed by the owner of this propeny to peAortn the wode tor Hfiich appliration is made and I comply with the <br />stace cor, � o��nW ie.z� GW and 296.200 WAG Q//v/ p� <br />r <br />