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To�. E Page L ot'7 20�4-03-0'1 O,i'..3F3:4F� (GMT) '1�884000383 Fr��r�i��. CJcl�orr�l� ShicicJs <br />SITE ADDRESS <br />502 74TH ST SW <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />ROBERT HARRIS <br />TENANT NAME <br />CONTRACTOR �A/ESCO <br />VV <br />� <br />s <br />PERMIT APPLICATION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATfONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX l.D. # <br />00708000009100_ <br />BLOCK I TRACT <br />PERMIT # <br />/`'t ii (J -1 " i�i�' <br />ADDRESS CITY/ZIP PHONE <br />502 74TH ST SW Everett g82o3 425-232-3202 <br />CpNTACT FOR PERMIT PHONE <br />JENNIFER COVELLO 206-774-9499 <br />ADDRESS CITY/ZIP PHONE <br />3909 196th St SW Lynnwood 800-398-4663 <br />coNTR. �.iceNse # WASH I ES971 OB <br />US� OF BUILDENG <br />RESIDENTIAL _ <br />WORK DESCRfPTION <br />REPLACE 50 GAL GAS WATER HEATER <br />� <br />PLUMBtNG <br />7YPE OF FlXTUf2E OR ITEM <br />Toilet <br />Baihtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />�ishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinai <br />�rinking Fountain <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURCE <br />Electric � Gas _ Other <br />CONTRACT PRICE OF WORK <br />950.00 <br />MECHANICAL <br />NO. I TYPE Of FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />� Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT L�CAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing tF�is type of work wili 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 />State Contractors Law 18.27 RCW and 29�„��(�,��I,P,���� _f, �o ��o <br />J e n n i f e r C o v e I I o �N <<,_�����f, � �o����o o-N�«hw�.,� F���»,� ���..��,. <br />�cmail=jcnnlfcc,,�nwpermiCcom, r—US <br />n.,��� �ni a n3 ?a � 3os��� -m�no� <br />Signature of Owner/Contractor/Authorized Agent Date <br />