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—� � . <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 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT A� <br /> 4331 THOMSON AVE 00605501400502 �I 1(7�— DO$ <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS QTY21P PMONE <br /> LAURIE LEER SAME AS SITE ADDRESSS Everett 98203 425-258-4576 <br /> TENIWT NAME CONTACT FOR PERMIT PHONE <br /> ICyndallNaida 36Q-945-2787 <br /> CONTRACTOR wESCO ADDRE35 QTY21P PHONE <br /> 28U0 Thorndyke SEATTLE 800-398-4663 <br /> coNrn.ucer+se a WAS H I ES971 OB <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> residential � _Electric �Gas_Other I 9rjQ.QQ <br /> WORK DESCRIPTION <br /> REPLAGE GAS 50 GALLON HOT W.aTER HE/�TER <br /> PLUMBIN(i MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> Tollet NC—air handling units <br /> Bathtub Forcetl air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower � Waterheater <br /> Kttchen sink R disposal _ Gas firepiace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/barlmopletc.) _ Ezhaustfan <br /> Backflow preventer _ Heat pump <br /> Urinal Untt heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstwe <br /> Root dralns Other <br /> Other <br /> dTV OF E:'L=RETT LOCAL SAIES TAX CODE IS 7105 <br /> I hereby caritify that I have read and examined this applicat;on and knowthe same to be true and correct. All prwisfons of laws and <br /> ordinaces governing thistype of work will be rnmplied with whether spr.cifieC herein or not.The granting of a pert*rt tices not presurtw <br /> to give authoriry to violate or canc2l the provision of any other state or local law regulating mnstruc[ion or the pertormance of <br /> construction. That I am authorized by[he owner of this prc�erty to pertorm the wnrk for whkh applica[ion Is made and I comply wtth the <br /> State Ccntractors Law 1827 RCW and 296200 WAC. <br /> T:'-,__.. 8/3/11 <br /> Slgnature of OwneUGontractorlAuthorized Agen[ ate <br />