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PERAIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 SS 3 <br /> 425-257-8810—FAX q25-257-8857—www,everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TFU(I.D.p <br /> 6226 2nd Dr SE PERMI7N <br /> 00784900005500 G <br /> LEGA LOTNO. BLOCK TRqCT <br /> oesc. LOT 55 BLK 00o D•0o RIDGEWOOD TERRACE DIV. NO. 1 <br /> OWNER ADDRESS <br /> CT'21P PHONE <br /> Kim Hye 6226 2nd Dr SE Everett 98203 425-923-5986 <br /> TENANT NAME CONTACi FOR PERMIT <br /> PHONE <br /> Melissa Croda 360-945-2787 <br /> COYTRqCTOR1A/ESCO AUDRE99 CITY2IP PHONE <br /> �� 2800 Thornd <br /> CONTR.LICENSENWASHIES971OB Yke SEATTLE 206-378-6649 <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _ Eloctric ✓ Gos Other <br /> 4578 00 <br /> WORK DESCRIPTION <br /> Replace 70 BTU gas to gas Bryant furnace <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURL OR ITEM NO, TYPE OF FIXTURE OR ITEM <br /> _ Toilet WC—airhandlingunits <br /> _ Balhtub i Forced air systems <br /> __ Lavatory(wash basin) Gas i in <br /> _ Shower — P P 9 <br /> _ Kitchen sink&disposal _ �'�'ator heater <br /> Dishwashor _ Gas fireplace <br /> Clothes washer _ Gas ranga <br /> Laundry tray _ Clothes dryor <br /> _ Sink(servicelbar/mop/etc.) _ Range hood <br /> BackOow proventer _ Exhaust fan <br /> Urinal _ Heat pump <br /> Dnnking Fountain _ Unit hea[er <br /> Floor drain _ Doiler <br /> __ Grease irap _ Refngeratlon <br /> Roofdrains _ Wwdstavo <br /> Olhar _ Other <br /> CITY OF EVERETT LOCAL SALES 7AJ(CODE IS J105 <br /> I horeby centily Ihal I have read and examined lhis app�ication and know the same to be tme and wrrect. All provisions oi laws and <br /> ordinaces c�overning this type of work will be complied with whether specified herein or not.The granting of a pormit does not presume <br /> to givo authority to violale or cancel ihe provision of any other state or local law regulating conshuction or tho perloimance ol <br /> consliuction.That I am authorized by lho owner of this proporty to perform tho work for which application is mada and I comply with the <br /> Slate CoMractors Law 18.27 RCW and 29G.200 WAC. <br /> �- �9=�� d .,�.z�7 <br /> Si�naturo o Owner/Contractor/Authonzed Agont Dat <br />