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PERMIT APPLIC/�TION <br />GITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. kVERETT, WA 98201 <br />425-257-881 D- FAX 425-257-8957 - wv�r+•everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />$IT[ ADOR�3u <br />7304 BI=VERLY BLVD <br />L[Gel IDTN�. OLOCK <br />OESC <br />PARCEL TAX I.D. d <br />00472300001900 <br />7RACT <br />8-dq��7 <br />PERM�T # <br />VRALPH BRIGMAN 7304 B[VtI�LY BLVD, Everett 98203 425-355-9521 <br />YENANT NAME I CONTACT FOR PERMIT PHONE , <br />Tania KeinecKe/Northwest Permlt Inc 360-945-2787 <br />CONTRACTOR ,NESCO ADORE34 CITV2IP PlIONE <br />COMRLICENSE� WASHIES9710B z800 Thorndyke Ave W seani�, 98199 206-378-6649 �I <br />USE OF DUILDING <br />Resiciential <br />HEATSOURCE <br />Eieeric x Gas _ Other <br />IWORK D[SCRIPTION <br />Replacing a 4 ton {3ryant AC - Rlodel #123ANA024 <br />NO. I TYPE OF FIXTURF OR ITEM <br />B3�htub <br />Lnvaiury (wash Lasin) <br />Shatver <br />Kitchen sink & tlisposal <br />Dishwoahcr <br />CIOIoeS washet <br />Laundry lray <br />Sink (SeNirn(badmnplplc ) <br />Backflow preventer <br />Urinal <br />Dnnking Fountain <br />Floor dra�n <br />Grease trap <br />Rvoi drains <br />OfhCf _ _. _ _ <br />CONTRACT PRIC5 OF WORK � <br />�3458.00 <br />N0. I TYPE OF FIXTURE OR ITEM <br />� A/C — air hantlling units <br />Forc�+d air systems <br />� Gas piping <br />� Water heater <br />Gas fireV�ace <br />� GBF ranpr <br />Clothes dryer <br />Range hootl <br />Exhaust fan <br />Hea� pump <br />Unit heater <br />� goiier <br />Refrigera6on <br />Wootlstave <br />ONer <br />Clri OF EVERETT LOCAL SAL[S TAX CODE IS �105 <br />I h�rnny ceritify ihat I have reatl and examinetl this aoaliCOtion antl know the same to be iNe and Co�TeCl. .411 pro'+isions of lav5 ana <br />ordinace. � gove.ming thi, type ��work vnll he comoiiea �+ith whether spedfied herein or not The grantmg of a permit does not presume <br />tn �ivr. authority lo vielate or cancel fhe piovision of any other state or local law regula0ng consWdion or the perfo�mance of <br />conslrucl�on. �ihat I am au�horized by the owner of this property to perfortn the �vrk for wfiich application is made and I wmply with the <br />State Cont[aLII1rs La�v 18.77 fjGVU a�tl 296.200 NJAC. <br />��gnntu7e of <br />