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03-23-'11 15:23 FRGM-nw permit 13609952091 T-369 P003/004 F-808 <br /> � <br /> PERMI7 APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI T, WA 9A201 <br /> 425-257-8310-FAX 425•257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `j - �i ��I� <br /> SITE ADDRESS PARCEL TAX I.U.tt PERMIT ff <br /> 5611 1ST DR W oastG600oo3500 (r11 I -03(0 <br /> LEGAL LOTNO. BLOCK TRAC7 <br /> DESC. <br /> OWNER ADDRESS CIiYIZIP PNONE <br /> DEAN 8 MICHELLE MCENANEY 5611 1 ST DR W Everelt 93203 425-609-8224 <br /> TENANT NAME CONYACT FOR PEtiMIT PHONE <br /> INaida Khan 360-945-2787 <br /> CONTRACTOR wESCO AODRE55 CITY2IP PHONE <br /> p 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSE N`^,^SH I ES97�OU <br /> VVf� <br /> USE OF BUILDING ViEAT SOURCE I CONTRAC7 PRICE OF WORK <br /> SFR I ,_electric �Gas_Olher $�@�(�lf.(o'o� <br /> WORK DESCRIPTION <br /> REf'LACE 60K GAS FURNACE; INSTALL 2 70N H[AT PUMP <br /> PLUMeING MECHANICAL <br /> NO, TYPE OF FIXTUR[OR ITEM NO. YYPE OF FI%TURE OR ITEM <br /> Tdlet NC-air hantlting unils <br /> �nthtub + Forcedairsystems <br /> _ Lavatory(wash basin) _ Gos piping <br /> Shower Water heate� <br /> 161chen sink d di,posal _ Gas firoplace <br /> Dlshwasher Gasrange <br /> � Clotheswashor _ Clolhesdryer <br /> Laundry Irny _ Ranpe hood <br /> � Sink(sorvice/bodmop/etc.) Exhaustfan <br /> 6ackllowprevonler i Heatpump <br /> Urinnl Unil healer <br /> D�inking Founlam ooiler <br /> � f-lootd�ain Rohige!alion <br /> Grease IrPp _ Woodstove <br /> Roof tlrains Olhor <br /> Other <br /> CIIY OF EVER[TT LOCAL SaLES TAX GOOE IS NOS <br /> I heieby catilify ihat 1 havu rend flnd examinetl lhis applicalion and know ihe samB lo be Ime antl Cortecl All provisions of laws and <br /> ordinacas govoming Ihis typo of�vork wili be compiletl��ith whether spocifiod herein ar no4 7he gran�mg ot a permil does not presume <br /> lo give nulhorily to viulatQ or enncel lhe provision of eny elher stote or lor.al law fagutaling consW tlion or Ihe pedortnence of <br /> conslruclion.That I am aulhorized by lhe owner of lhis p�operty to pedonn Ihe work fOt which applicalion is made and I comply wilh the <br /> Stalc Contraclors Law 10.27 RCW and 296.20D WAC. <br /> o,3/a�I�DII <br /> Si�nature of Owne ontraclor n=e go �ate <br /> I <br />