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i o: C rage ;� or v ��� �+-vts-ub [u:vy:4� (c�ivi i) � tststs4u����� rrom: veeoran :snieias <br />SlTE ADDRESS <br />413 74TH ST SW <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />JOHN A MIKELSEN <br />TENANT NAME <br />PERMIT APPLICATiON <br />ClTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICAT[ONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />00708000008500 <br />BIOCK I TRACT <br />CONTRACTQR �q/ESCO <br />VV <br />coNTR. ucEr�sE # wASH I ES971 OH <br />USE OF BUILDING <br />RES <br />WORK DESCRIPiION <br />ADDRESS CITYIZ(P <br />413 74TH ST SW EvarPtt 982n. <br />CONTACT FOR PERMlT <br />J�NNIF�I-Z C�UV�LLU <br />A�DRESS CITY/ZtP <br />3909 196tF� St SW Lynnwood <br />REPLACE 50 GAL GAS WATER HEATER <br />� <br />NG <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinai <br />Drinking Fountain <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURCE <br />Electric � Gas _ Other <br />� <br />ERMIT # <br />� I �-I c;� — c:; f <br />PHONE <br />'� 425-347-1344 <br />P410NG <br />206-774-9499 <br />PMONE <br />800-398-4663 <br />CONTRACT PRICE OF WORK <br />$g5a.00 <br />NICAL <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas flreplace <br />Gas range <br />Cloihes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />C{TY OF EVERETT LOCAL SALES TAX CODE !S 3905 <br />i hereby ceritify that I have read and examined this application and know the same to be true and correct. All provislons of laws and <br />ordinaces 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 locai 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 appiication is made and I compiy with the <br />State Contractors La//w�� 18.27 RCW and 29C�,��(�,�/�1�,�,�n��r«co����o <br />J^�� I�/� �� O`/� I l O DN: m=lcnnifcr Covcllo, n=Northwcst 7crmit lnc, ou, <br />C C V email=jcnnifcr,,�novpermitmm,c=US <br />nrr�� �ni a n> >a i rar,�i �-m•no� <br />Signature of Owner/Contractor/Authorized Agent Date <br />