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To Permit Department Page 3 of 5 2014 06-25 23 23 :o (GMT) 18884000383 From. Deborah Shields <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 <br />PARCEL TAX I.D. # <br />PERMIT # /- <br />M ��O�!-0r7 <br />203 73RD ST 5W <br />00437582702700 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITYrLP PHONE <br />TERRY PALMER 203 73RD ST SW Everett 98203 425-923-8446 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Naida Khan 360-945-2787 <br />CONTRACTOR Washington Energy SONICeS ADDRESS CITYrLP PHONE <br />3909 196th St SW Lynnwood 800-398-4663 <br />CONTR. LICENSE .WASHIES971 OB (Wesco) <br />USE OF BUILDING <br />HEAT OURCE <br />CONTRACT PRICE OF WORK <br />SFR <br />_ Electric V/— Gas _Other <br />$4116.80 <br />WORK DESCRIPTION <br />INSTALL 33K GAS FIREPLACE INSERT WITH 10' GAS PIPING. <br />PLUMBING <br />MECHANICAL <br />N0. TYPE OF FIXTURE OR ITEM <br />NO, TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C - air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />1 <br />Gas piping <br />Shower <br />Water healer <br />_ <br />Kitchen sink 8 disposal <br />i <br />Gas fireplace <br />_ <br />Dishwasher <br />Gesrange <br />_ <br />Clothes washer <br />_Clothes <br />dryer <br />_ <br />_ <br />Laundry tray <br />Range hood <br />Sink (servlcelbadmopletc) <br />Exhaust tan <br />_ <br />Backfiow prevenler <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />Fountain <br />Boiler <br />_Drinking <br />Floor dram <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE 19 9105 <br />I hereby centity that 1 have read and examined this application and know the same to be true and coned. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contractors Lew 18.2Z RP� EinagiS pd •ea/ ylgned Or Nride Khan <br />N DN <n-Nelda Men o•NorthwmVe/mN <br />�21)� � � Inc, ca. email=nelde®nwpermtt corn. c.US <br />ignature o Ownerl onlrectorl ut orize gent'l0TM0°631V°eoleo <br />