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7o E Page 2 0l 3 :014 U7-17 00 2� 28 (GMT) �9d84000303 From Debo�ah Shields <br /> _' — • • <br /> � PERMI`i APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT WA 98201 <br /> 425-257-9810 - FNC 425-257-8f357 - www everettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS I PARCEL TAX I D.B P[RMIT p <br /> 2101 BAKER AVE _ � oo553to��oO�Oz _ _1 �/NQ� <br /> ' IEG�I LUTNO. BLOCK � TRACT <br /> II DFSC � �_— � ._ <br /> �. OWNER ADDRESS CITV/21P PHONE <br /> � JILL WUEiEiENHORST 2101 BAKER AVE Everelt 9H703 425 374-8208 PAUL <br /> ' --- - --- - - -_ _ — - <br /> ' TENAl1T NAME CONTACT FOR PERMIT PHONE <br /> � IJENNIFER COVELLO 206-774-9499 <br /> � - ------ --- -- - -- - <br /> CONTRACTOR �A/ESCO AD�RESS CITYIZiP PHONE � � <br /> �� 3909 196th St SW Lynnwood 800-398-4663 <br /> CONT0.�ICENSE R WASHIES971 OB <br /> ____.._._ __' ..__—.__ --_ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> RESIDENTIAL _Fiea,�� �ca5 __o,n�� 750.00 <br /> WORK DESCRIPTION � <br /> ' REPLnCE GnS WnTER HEl1TER <br /> � -- -- <br /> PLUMBING MECHANICAL <br /> NO TYPE OF FI7(TURE OR ITEM NO TVPE OF FI%TURE OR ITEM <br /> TOilet WC -a�r hantl6nq un;(s <br /> pathtub Forcetl au systems <br /> Lavatory(wash bas�m _ Gas piping <br /> Shower VVate�heater <br /> Kddien sinh 8 d�rVos.it ___ Gas fi�ePlace ,, <br /> D�shwasher Gas range <br /> Ciothes wa;he� Clothes tlryer <br /> Launtliy Iray Rangc hvod <br /> Sinh (scrvic?ibar/rnop'etc 1 E.hau;l lan <br /> 9achflow preventcr _ Neat purnp <br /> _ Unnal _ Um�hcate� . <br /> Dnnkinq Foun�a�n _ Dotler � ' <br /> _ Floor drain I Refnyeration � <br /> Grease trav Woodstove <br /> Roof diams Other <br /> Othcr <br /> CITY OF EVERE�T LOCAI SALES?AX CODE IS J105 <br /> 1 here�y cenldy Ihat I have read and e.amined INs apphcation and�know Uie same to be true and cortect A11 prov�;�ons o�law,and <br /> ordmaces govem�ng this rype of work w�ll be comphed wdn whether speuhed herein or not The gran6ng ol a perrnd dues nol presume <br /> to yive aulhonty to viola�e a cancel ihe provision ol any o�her slate or local law regulating construd�on or Ihe verlormance ol <br /> construclion 7 hat I am authonr.ed by Ihe owner of th,property to pertcrm ihe work for which applicabon�;matle and I comply wdh�he <br /> Stale Contracbrs Law 18 27 RCW and 29��,QQ„�,A��,,,,,,«,�„ <br /> Jennifer Covell� �'� � ' '���� �"m -�°°��'° �°., <br /> i.�.n:r,.✓..,�,,.r�,.n�e �..w <br /> �uJn�^ <br /> Siynature ol OwnerlContractonAuthonzed Agent Date <br />