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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. # <br />PERMIT # <br />I <br />1711 21st St 00437042301702 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />t4att Runte 1711 21st St 98201 425-258-6268 <br />TENANT NAME <br />CONTACT NAME PHONE <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE# <br />Day & Nite, INC 16614 13th Ave 11 98037 DAYNIPH044CH <br />PHONE <br />425-775-6464 <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />Addition <br />HEAT SOURCE <br />PERMIT <br />I.R.( Combination l-.�(' Plumbing <br />WORK <br />Alteration <br />1�cpy� Electric <br />TYPE <br />I..J Demolition I� Sign <br />TYPE <br />I <br />New <br />Lj Gas <br />House <br />U Sprinkler <br />Repairltdaint. <br />L�`jjj Other <br />7— <br />CONTRACT PRICE OF WORK 6500. 00 <br />I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />Install new heating system, new heat pump and air handler <br />plus new ductwork in house. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />_I <br />A/C— AIHANDLING UNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />_ <br />KITCHEN SINK & DISPOSAL <br />CLOTHES DRYER <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />_ <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFLOW PREVENTER <br />GAS PIPING <br />_ <br />_ <br />SINK (SERVICE/BAR/MOPIETC.) <br />_ <br />EXHAUST FAN <br />OTHER <br />OTHER --- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME- TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />RA CONTC fJW D 196.200 WAC. <br />�8.271jCW <br />Siginature a ntractor utthhoned Agent Date <br />