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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 T©4 PAA <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> and 1411 Madrona Avenue 00505700003205 & OOSOS 3206 <br /> _ -- I V_)l 005-0)3 <br /> LEGAL� LOT NO. BLOCK TRACT OR SUBDIVISION ft <br /> DESC, 4 A portion of Lot 32 , e Heights <br /> OWNER ADDRESS IZIP PHONE <br /> Jae Hong 1409 Madrona Avenue, Ev tt, 98203 206-234-4044 <br /> TENANT NAME CONTACT FOR PERMIT PHONE 425-258-9308 <br /> Reid Shockey <br /> rshockey@shockeybrent.com� <br /> lE-MAIL <br /> CONTRACTOR ADDRESS CITYIZIP PHONE <br /> To be determined. —_ <br /> CONTR.LICENSE <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ale� <br /> N/A Electric Ga —Other <br /> —/ .. - -1........... <br /> WORK DESCRIPTION <br /> Remove two retaining walls from uppe tion of steep slope. Restore grade, <br /> :plant native vegetation to provide 1 -term slope stability, install new <br /> Ikeystone blocl?' retaining wall and rcase. -W <br /> -2 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM r"> NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink& disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink (service/bar/inopletc) <br /> Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinances 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 /> �ate ontractors Law 18 7 RCW and 296.200 WAC. <br /> I (m I,-&. _ — — 1/3 A0 <br /> gign'atUre of 0­w-n6r/Co_ntractor/ uthorized Agent Date <br /> ................ ................... <br />