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� <br /> PERMIT APPLICATI�N <br /> CITY OF EVCRETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810– FAX 425-257-8857–ww�+v.ever=ttwa.org <br /> APPLICATIONS ARE ACC[PTED FROM 8 AM TO 4 PM I �'�U `'� 3 <br /> PARCEL TAX I.D.# PERMIT# /�I <br /> SITE ADDRESS � - ��� � ,�U 5 <br /> 1109 41 st SE o0596200300702 <br /> LECAL LOT NO. BLOCK TRACT <br /> DESG � <br /> OWNER ADDRESS CINIZIP PHONE <br /> Maureen Stevens 1109 41 st SE EvereU 9820? 425-252-2729 <br /> CONYACT FOR PERMIT PHONE <br /> TENANT NAhiE 360-945-2787 <br /> Naida Khan <br /> CONTRACTOR AODRE55 CITY2IP PHONE <br /> Home Depot At Home Services 140 County Line Rd, #101 PACIFIC 800-381-5699 <br /> CONTR. LICENSE# IJOMED*�972RQ - <br /> 11 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _Ele�:ric _Gas_Other I $$���.�� <br /> WORK DESCRIPTION <br /> REPLACE 17.3 SQUARES OF COMPOSITE ROOFING; REPLACE 6.3 SQUARES NCI <br /> DECKING. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM <br /> NO. IYPE OF FIXTURE OR ITEM <br /> A/C–airhandling unrts <br /> _ Toilet F�rced air systems <br /> _ Bathtub Gas piping <br /> Lavatory (wash basin) Water heater <br /> _ Shower Gas fireplace <br /> _ Kitchen sink& disposal Gas range <br /> _ Dishwasher Clolhes tlryer <br /> Clothes washer Ranae hood <br /> _ Laundrytray E�haustfan <br /> _ Sink(service/bar/mop/etc.) — Heat pump <br /> Bachflow preventer — Unit heater <br /> _ Urinal Boiler <br /> _ Dnnking Fountain Refrigeration <br /> Floor drain Woodstwe <br /> _ Grease trap Other ' <br /> Roof drains — " <br /> Other — <br /> — I <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify Ihat I have read and examined this application and know the same to be true and correct All prrnisions of laws and <br /> ordinaces governing thistype of wo�k v�nll be complied with whether specified herein or noL The granting of a permi:does not presume <br /> to give authority to viola[e or cancel the provision of any other state or local law regulating construction or the pedormance of <br /> construclion. That I am auihorized by the owner of this property to perform the work for whkh application is made and I comply with Ihe <br /> State Con[ractors Law 1827 RCW and 296200 WAC. n��q��i,�.:y s:qnen by N��d,nnan <br /> , �� � DN:rn=NaiAa Nhan.o-Norinwest <br /> �< <"� '� Perml�inc,ou, <br /> n��1 a n_���._. <br /> Signature of Uwner/Contracto�lAumon_ed Agent Qate ��m,n=n,�aa��m+me�m��.com.c-us <br /> o,�c zoiiut.t3zus3:x� os'ao• <br /> �..—..�.,.-.–.---.�.r,-,�-+a�.^p;._� <br /> ,'�'L <br />