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I- .- p..y.. .. n. .O Zo. a.o..pn 1100 .o (.. " ...nn.000nuD <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-6810 - FAX 425-257-8857 — w ww everethva org <br />SITE ADDRESS <br />4534 SEAHURST AVE <br />LEGALI LOT NO. <br />DAISUKE URIU <br />TENANT NAME <br />CONTRACTOR , ^ /CSC O <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. a PERMIT a ' I <br />00505700001101 rn i u 01 -- <br />BLOCK <br />TRACT <br />ADDREFS CITYRIP PHONE <br />4534 SEAHURST AVE EveieU98023 425-252-7327 <br />CONTACT FOR oERMIT <br />!Jennifer Covello <br />PHONE <br />206-774-9499 <br />CITYIZIP PHONE <br />Lynnwood 800-398-4663 <br />CONTR. LICENSE 0 WASHIES971 OB <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br />RES _UectncIt Gas _Other $950.00 <br />WORK DESCRIPTION <br />ADDRESS <br />3909 196th St SW <br />REPLACE 50 GAL GAS WATER I-"�A I -ER <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ I odet <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />_ Kitchen sink 8 disposal <br />_ Dishwasher <br />_ Clothes washer <br />_ Laundry tray <br />_ Sink (service/bar/mopletc ) <br />_ Backflow preventer <br />_ Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />_ Grease trap <br />_ Roar drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ A/C - air handling units <br />_ Forced air systems <br />Gas piping <br />I Water healer <br />_ Gas fireplace <br />_ Gas range <br />_ Clothes dryer <br />_ Range hood <br />Exhaust ran <br />_ Heat pump <br />_Unit heater <br />_ Boiler <br />_ Refrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be We and correct All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18 27 RCW and 29� 2 WItiC <br />NOr+p hnMnrCnfl° <br />Jennifer Covello <br />Pupr.ni Pbrugr, fmPP.11nM<rpn..y[rmi:<°m, c•Ut <br />Signature of Owner/Contractor/Authorrietl A§ fit'Y'r Date <br />