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1 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> J200 CCDAR STRCET, CVERETT,WA 9E201 <br /> ; 425-257-BB10—FAX 425-257-8657—www.everettwa.org <br /> i APPUCF.TIONS ARE ACCEPTED FROM 8 AM TO 4 PM (� � -0 O <br /> I <br /> SITE ADORESS PARCEL TAX I.D.N PERMR M <br /> 1617 RUCKtR A UCJ 00438034200800 1 ��C�/-�] <br /> IEGAL LOTNO. BLOCK TRACT <br /> D[SC. <br /> OWNER Af10R[SS CITYZP PHONE <br /> NEAL SHANNON 10 i7 RUCK[R, Evereli ?8201 425-259-6440 <br /> TENPNT NAME I CONTACT FOR PERMIT PfiONE <br /> Naida Khan/Northw�st Pormit Inc 360-�45-2787 <br /> CONTRACTOR W�SCO ADDRE53 CITY2IP VHONE <br /> CON7R.LICENSE� WASHIES97106 2800 Thorndyke Ave W Seattle, 98199 206-378-6649 <br /> �� USE OF 9UILOING I NEAf SOLIRCE CONTRAGT PRIGE OF WORK <br /> 1 <br /> ' Residential _E��:��� X_Gas_Other �950.00 <br /> WORK DESCRIPTION <br /> Replacin� a Bryant gas to gas 110K btu furnace <br /> PLUMBING MECHANICAL <br /> ' N0. TYPE OF FU(TURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> _ _'__.._—_—_._... _ . ,_. . ,. . . _ . � <br /> Toilet A/C—air handling units <br /> Bathfub � ForcedairsYslems <br /> � lavatory(wash 6asin) _ Gas pipirg <br /> � Shower Waterheater <br />� Kiichen sink 8 disposal _ Gas fireplace <br /> Oi,hwasher Gas range <br /> �` aotnes wasner � ciotnes aryer <br /> iaundry tray _ Range hood <br /> Sink(seNice/bar/moplelc) Exhaust fan <br /> � -- Backfl�wpieven�ei _ �ea�N�'��P <br /> Urinal Unit heatet <br /> � Drinking Founta'n ,_ Boiler ' <br /> � Ploor drain _ RCfd9c�ntion <br /> Grcase trap Woedstove <br /> Roof drains � Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br /> i hereby ceritiy that I have reod and examined this appliwtion ond know the same to Ee tnie and corred. AII provisioos of laws antl <br /> uid iie�ea yuveinlny lliis lyyc o(wuih will Le�tilmplieJ wilh wltelhei spn�iGeJ Leiei�i or irol The yianliny o(a pcimil Jue9 i101 presumc <br /> �� to E�ve authonty to violate or cancel the provision o(any othar state or local law regulatinp construction or lhe pertormance of <br /> mnstrudion Thal I am aulhorizetl by ihe o�mer of this property fo ped nn the ark tonvhich appGcaGon is made and I comply with the <br /> Gtote Contm Lpw 18. G 9 antl:flG.200 WAC. <br /> �� � � �� �. <br /> Sir�nutur?nf QwnrrlCn .r ctnr/Authnm.Pd Pr�nn( Date <br />