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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> q25•257-8810— FAX 425257-8857—wwad.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE55 PARCEL TAX I.D. # PERMIT # <br /> 2211 BAKER AVE 0055310�800500_ r(1 �?i�i� — ��`{ �;_ <br /> LEC3AL, LOTNO. BLOCK TRACT <br /> °� - -L---- �- -- <br /> OWNER ADDRESS pTV21P PHONE <br /> JACK L DURR 2211 BAKER AVE Everet�9e2o� 425-239-7127 __ <br /> TEIJANT NAME CONTACT FOR PERMIT PHONE <br /> Jennifer Burgess _206-774-9499 <br /> CONTRACTOR �A/ESCO �+�DRESS pTV21P PHONE <br /> �� 3909 196 St SW, ��'��,W�od sausa $p0-398-4663 I <br /> CONTR.LICENSE N WASHIES971 OB _____ <br /> USE OF BUILDING HEAT SOURCE CONTRAGT PRICE OF WORf< <br /> Residential _e�e�<<�� �Gas_Other I 7�j� _ <br /> �— <br /> WORK DESCRIPTION <br /> RFPI_ACE 50 GAL GAS WATER HEATFR <br /> PLUM8ING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. NPE OF F:XTURE OR ITEM <br /> Tonct A/C - air handhng unds <br /> BatntuU _ Forced an;ystems <br /> Lavatory (wash basnl _ Gas piping <br /> Shower � Water heater <br /> kitchen sinh 8 tlisposal _ Gas f�replace <br /> DiShwashC� Gas ra�ge <br /> Clothes washer Clothes tliyei <br /> l.aundry tray _ Ran,c,e hood <br /> Sink (service/baUmop/etc� _ Exhaustfan <br /> Backtlow preventer _ Heat pump <br /> Unnal Unit heater <br /> � UrinkingFoun!_�n _ 8oiler <br /> Ploor drain RefrigeraUon <br /> Grease trap _ Wootlstwe <br /> Roof tlrams Other <br /> �ther <br /> CITV OF EVERETT LOCAL SALES TN(CODE IS 31D5 <br /> i hereUy centdy that I have read antl enamined this application and hnow[he sarne to be true and correct All prwlsions o(laws antl <br /> ,rcfinaces 9ovemmg Uus type ot�wrk vnll be comphetl wrth whether specihetl herem or not The gr.inting of a permR tloes nol presume <br /> eo grve authonry to viniatr or rancel the provision of any othei state or local law regulating oonsirdrtion or the pertormance of <br /> c�on>nuRion 1'�,it ! ac, authrrr_ed by Ihe owner of this property to perform the owrk for whrh appl ca0on is matle and I comply wdh the <br /> St�te Con;ractors 1 aw 1�a :; RCW and 296 200 WAC <br /> I l.i���U.l�•r':;�h:�•�Il�t Xu�jral <br /> Jennifer Bur ess 111 n �rvYnNurireaN:tM11Nd5�11F�.•ileu „w,,,:.,,, <br /> wwu ..om p..rn..n,+.pmmc,,:m r.u) <br /> SignatuieotG:GneriConLacto Authon:rd en "'""�� �� ate <br />