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.o� �. c.�o ,� _ � .�_ �_.i_�r� <br />� <br />• <br />..,..�.�000:�u.. r.o.., u..��o.e.� _.. .. �.. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT VVA 98201 <br />425-257-8610 — FAX �25-257-8857 — w;vvd.everct�wa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I SITE A�DRESS j PARCEL TAX I.D. # ! PERMIT d �j <br />I 10415 9TH DR SE i o0097000004zGo I�����% — �/ �� <br />� LF�.;H ; LOT NO BLOCK I TRACT ' <br />, (�E5�1_—_ � I -__—_— - '� <br />OWNER ADDRESS CI7Yl21f PHONE <br />i CODY DORN 10415 9TH DR SE Evereu 9�2G8 425-355-9799 __ <br />TENANT NA�dE CONTACT FOR PER�l1T PHONE I <br />Naida Khan 360-945-2787 <br />CONTRACTOR 1A/ESCO AUDRE55 � CITY2IP PMONE <br />VV 3909 196th St SW Lynnwood 800-398-4663 <br />; CON7RLICENSEsWASHIES9710B <br />USE OF BUILDING '�. HEAT SOURCE <br />SF{� ' _ E'ectnc � Gas _ otner <br />WORK DESCRIPTION � <br />REPLACE 6CK GAS FURNF�CE <br />PLUMBING <br />Np. I TYPE OF FIXTURE OR I'i Etd NO. <br />I _ Talet <br />Balhtub <br />� I avainrv (wa5h ba5inl <br />I Shower <br />� Wtchen sink & d�sposal <br />Di,hwasher <br />CloUies washer <br />. laundry vay <br />g�nk �;ervice/badmoF�etc ) <br />Backflow prevenier <br />Unn31 <br />. Dnnking Founl2in <br />Floor Grain <br />Grease trap <br />Roo� drains <br />Other <br />CONTRACT PRICE OF WORK <br />$3362.60 <br />MECHANICAL <br />TVPE OF FI%TURE OR ITEM17 <br />A/C - air h2ntlling unil5 <br />� ForceC au systems <br />Gas p�ping <br />Watei heater <br />Gas fireplace <br />G:is range <br />Clothes dryer <br />Ranae hontl <br />Exh�Ust fen <br />Heai pump <br />Unit heater <br />Bo�ler <br />Refr�geration <br />\Noodsrove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cenUfy Ihal I have read and examinetl this application and know Ihe same to be true and ccrrec! All provisions of law, and <br />ordinaces governing th�s type ol work will be complled wdh whether speulied herein or no! The grantinp o! a permit does nct presume <br />to g�ve authonly to wolafe or cancel the prov�,ion of any o�her stale or Iocal law reyWating construaion or the Fe�tormance of <br />con,tructicn That I am author�zed by Ine owner of th�s property to perform the work for which application is matle and I comply wnh the <br />State Contradors Law 18 27 RCW and 296 200 WAC. <br />1 o,���auv „�,a� �� r:��da z,z� <br />A � � � N^� ��^1 V1 Dtt rn=t:eqa N�an o= nor.n..es: 'e,rn� <br />�. signa�weoruwneut,on�rac�or��w�no���:uhur��io.��.:oi�riozo37 <br />��.-- - -- ---_.— —. <br />