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09-22-'11 1D:50 FROM-nw permit 13609952�S1 T-507 POOL/OD3 F-392 <br /> _ _ __ <br /> ---- --.--------- . PE�MIT �4PPLICATIO�J _ - - - - ---- <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE[T, EVERETT,WA 9d201 <br /> 425-257-8810-FAX 425-257-8857-wNnv.evereKwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AODRESS PARCGL TAX I.D.# Q,ERMIT N ., — �� <br /> 6308 1 st Drive SE o078490000�50o J i�i <br /> LEGAL LOTNO. BLCCK TRACT <br /> DESC. <br /> OWNER ADORE55 CITY2IP PHONE <br /> Paul Lemke 6308 1st Drive SE Everell98203 425-355-2927 <br /> 7ENANTNAME CONTACTFORPERMIT VHONE <br /> INaida Khan 360-945-2787 <br /> cor+rrtncrore Home Depol At Home Services °aorsess cirnziP PHONE <br /> 140 County Line Rd, #101 PACIFIC 800-381-5699 <br /> CONTR.LICENSE� HOMED�"972RQ <br /> USE OF 6UILDING FiEAT SOURCE CONTRACT PRICE OF WORK <br /> S FR I _Elactrie _Gas_Other $14653.97 <br /> WORK UESCRIPTION <br /> REPLACE 30 SQUARES OF COMPOSITE ROOFING; R[PLACE 7 SQ. PLYWOOD <br /> — PLUMBING MECHANICAL <br /> NU. TVPE OK FIXTl1RE OR ITEM NO, TYP[OF FIXTURE OR ITEM <br /> 7oilel NC—air handling unils <br /> Balhtub � Forced air sys�ems <br /> Lavatory(wasn Uasin) _ 3as piping <br /> � Shower Water healer <br /> Kilchan sink 8 d�sposal _ G2s freplaco <br /> Dishwasher __ Gas range <br /> Clolhes washor _ Clolhes dryer <br /> ~ Laundry troy __ Rango hood <br /> Sink(sorvica/Uarmiop/elc.) __ Exhaust fan <br /> � OackOowpreventof _ Heatpump <br /> Urinal Unit healer <br /> �nnking Founlain 6oilar <br /> Floordrain ~ Roftiqaration <br /> Grease Vap Woodslove <br /> = Raol d�8in5 I = Othcr <br /> Olher <br /> CITY OF EVERETT LOCAI SAlB57Wc COOE IS 71a5 <br /> I hefeby te�ili�y lhal I have read and exerttilled lhis application and hnow Iha sa07o lo bo truo�nd torred. All provisions ot I�wS 8Bd <br /> ordmaces govemntg Ihis type of werk will be comp6od tvilh wholh�r specified herein or not.Tho granting ol a pennit dnes nol presume <br /> to give authoriry to vioiale or cancoi the provision of any other state or local Iaw regulating conswction or the pedormance uf <br /> construction.That I am aulhorizud by the owner of lhis property lo perform Ihe�vorh for which apphcalion is mado sntl I comply with the <br /> Stato Con�ractors Law 18.27 RCW and 296.200 W G <br /> G� ��?z�2c� �l <br /> Siynature of Ownor/Contractor/ w ri'z d �t Date <br />