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\ <br /> F�ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—vwwv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �p J����� <br /> SITE ADDRESS PP.RCEL TAX I.D.N PERMIT# <br /> 1908 BROADWAY o0437938302800 /Q - 3 <br /> LEC4L LOT NO. BLOCK TRACT <br /> DESC. <br /> OYYNER qDDRESS qTY21P PHONE <br /> KENNETH STANNESS same as site address 98201 (360) 658-0931 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Cyndal/Naida 360-945-2787 <br /> CONTRACTOR WESCO ADDRESS QTY21P PHONE <br /> 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSE k,^/AS H I ESg7�O B <br /> VV <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> C851C�@IltlB� _E�ectric �Gas_Other I 5000.00 <br /> WORFt DESCRIPTION <br /> REPLACE GAS 75 GALLON HOT WATER HEATER <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Tollet A/C—alr handling units <br /> __ Bathtub Forced air systems <br /> _ Lavatory(wash basln) Gas piping <br /> _ Shower � Water heater <br /> _ Kitchen sink 8 disposal Gas firepiace <br /> Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> _ Sink(service/badmop/etcJ Ezhaustfan <br /> _ Backflow preventer Heat pump <br /> Urinal UnR heater <br /> Orinking Fountaln Boller <br /> _ Floor drain Refrigeration <br /> _ Grease trap Woodstwe <br /> Roof dralns Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify that I have read and examined this application and knowthe same to be true and correct. All prwislons of laws and <br /> ortlinaces governing this type of work will be mmplied with whether specified hereln or not.The granting of a permit tloes not presume <br /> to give authoriry lo violate or cancel the provision of any other state or local law reguiating mnstruction or the pertormance of <br /> construction. That I am authori�ed by the owner of this property to pertorm the wnrk for which application is made and I mmply with the <br /> Sfate Contractors Law 18.27 RCW antl 296200 WAC. <br /> 1 , <br /> �,=:� ---=�: 10/13/11 <br /> Signature o OwnerfContractor/ uthorizetl Agent Date <br />