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To�. Gry of Everett Page:ol 3 207a-OB�OS 07 4131 (GMI� �a80a000383 Ftom Debo!ah SIVCICS <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810– FAX 425•257-8857 –www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � –O6" I� <br /> SITE ADDRESS PARCEL TAX I.D.!J PERMIT# <br /> 4811 SeahurstAve 29043600308600 �g '��� <br /> LEGl�L LOT NO. BIOCN TRAGT <br /> DESC <br /> OWNER ADDRESS CITVILP PHONE <br /> Christine Farley 4811 SeahurstAve [vcrclt98203 360-421-2820 <br /> TENANTNAME I CONTACTFORPERMIt PHONE <br /> INaida Khan 360-945-2787 <br /> CONTRAC;oR Home Depot At Home Services pODRESS CITYILP PNONE <br /> 140 County Line Rd, #101 PACIFIC 800-381-5699 <br /> CONTR LICENSEtrHOMED'*972RQ <br /> USE OF BUILDING HEAT SOURCE CCNTRACT PRICE OF WORK <br /> SFR I _E�er,nc _Gas_Otner $6,083.30 <br /> WORK DESCRIPTION <br /> n.,.,i,..,�. �r_ ,......_..... ,.r .�.......,,,.:�,. ....�r...., r.i.. ..i�.........i ..�..i.....,._..,... <br /> re-ra� <br /> — PLUMBIhG MECHANICAL <br /> N0. TVPE OF FI%TURF OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Todet NC—air handhng unns <br /> Balhtub _ Forced air systems <br /> Lava�ory(wash basin) _ Gas pipmg <br /> 5hower __ Waterheater <br /> KdUien smk &disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clo;hes washer C'othes dryer <br /> Laundry tray _ Range hood <br /> Sink(serviceibodmopietc) _ Exhaust lan <br /> �ackflow Vrevenler _ Heal Dump <br /> Unnal Unit hcatcr <br /> Drinking Pounlam _ Boiler <br /> Floor dram Re(ngcration <br /> Gmase trap Woafslove <br /> Roof drains Other <br /> -- O�hcr <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS J105 <br /> I hereby cenhfy that I have iead and enammed this apphcation and know the same lo be Irue and cortect !11! prov�sions ol laws and <br /> ordinaces goveming Ihis type ot work Hnll be compiied with whether specified herein or nol The granLny ot a permd docs not piesume <br /> to yrve authonty lo v�olate or a�ncel Ihe pwvision of any other s�ate or local law regulating construdion or the pedo�mance ol <br /> construclion. That I am aulhorized by the owner of this properry to perform the work lor which applicafion is made and I comply with Uie <br /> State CoNractors Law 18.27 RCW and 2�36.200 WAC. <br /> Kathleen Genge �"��=-"^:�T ^.M��.L,^�.�_a,�" <br /> �w�,.,.,,o <br /> Signature ol OwnedContradoUlluthorized Agent Date <br />