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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-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TrJ 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 4719 5[h Avenue W 007667900001300 �p7p�{ - DZ <br /> LEGAL LOTNO. BLOCK TRACT <br /> oesc. / 3 00o D_nb � �zc.rtiwou � I�� KFF <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> SCuart Downer 4719 Sth Avenue W Everett 98203 425-259-5935 <br /> TENANTNAME CONTACTFORPERMIT PHGNE <br /> Stuart Downer S1m Holden 425-746-3077 <br /> CUNTRACTOR ADOREcg CITY2IP PHONE <br /> All Climate Heating & A/C 14715 N.E. 95th Unit ri Redmond, `.�A 98052 425-746-3077 <br /> I CONTR.LICENSEp ALLCLCH966C6 <br /> USE OF BUILDING — HEAT SOURCE I CONI RACT PRICE OF WORK <br /> Electric _Gas_Other <br /> WORK DESCRIPI'ION <br /> Iastall gas piping from furnace to kitchen range locatioa. <br /> IPLUM8ING MEGHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR I1�EM <br /> Toilet _ A/C-air handling unils <br /> BalhtuU Forced air systems <br /> Lavalory(wash basin) �_ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink&disposal _ Gas(ireplace <br /> Dishwasher _ Gasrznge <br /> Clothes washer _ Clolhes dryer <br /> Waler healer _ Range hood <br /> Sink(servicelbarlmop/elc.) _ Exhaust fan <br /> Dack(low prevenler _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain _ RefrigeraUon <br /> Grease lrap _ Woodslove <br /> Roof drains _ Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y lhal I have read and examined lhis application and know the same to be true and correcL All provisions of laws and <br /> ordinaces yoverning lhis type of�mrk will be complied with whelher specitied herein or nol The granting of a permit does not presume <br /> to give authoriry lo violate or cancel lhe provision oi any other state or local law regulating conslruction or the performance o( <br /> construclion.Thal I am authorized by the owner of this property lo perform lhe work for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> ��',,...,,. ' .< � t-T: 4-10-07 <br /> Signature 0(OwnedContracto/Authorized Agent Dale <br />