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PERMIT �1PPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STR[ET, FVEFETT, WA 9820� <br /> 425-257-5810—FAX 425-257-8857—www.evereriwa.org <br /> �PPLICATIONS ARE ACCEPTED FROM 8 AM TO a PM �I —� 3 .O� <br /> S�TE ADDR[SS PARCEL TAX I.D.# PERMIT A <br /> 2210 BROADWAY 00439147502800 Plo 11� -� � <br /> LEGA LOTNO. BL04K TRAC7 <br /> DESC. <br /> OWNER ADDRESS C11Y/;IP pHONE <br /> CLIFTON ERVIN 2210 BROADWAY, Everett 98201 4Z5-259-2817 <br /> TENANTHAIdC- I CONTACTPORPERMIT PHONE <br /> Naida KhaNNortllwest Permit Inc 360-945-2787 <br /> CON7RACTOR w�SCO ADDRESS G7YTP PHONE <br /> CDNTR.UCEHSE� WASHIES9710B 2800 Thomdyke Ave W seatt�e,98199 206-378-6649 <br /> USE OF BUILDING NEAT SOURCE CONTRACT PRICE OF YVORK <br /> Residential _����� X C+?9_Other I �s5o.00 <br /> WORK D[SCRIPTION <br /> Replacing a gas to gas 40 gallon w�ier heater <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXNRE OR ITEM NO. iYAE OF PI%TURf OR ITE1A <br /> _ Tolet A/C–air handling units <br /> _ 8alhtub Forcedairsystems <br /> _ Lavatory(wash basin) � Ges piping <br /> Shower � Water heater <br /> _ Kitchen sink 8 disposol Gas firnplace <br /> Disnwasner � �as r.3nge <br /> Clolhes washer � Clothes dryer <br /> Laundry tray Range hood <br /> _ $ink(service/6arhnop/eLc.) Eichaust fan <br /> _ 8ackflow�reventer Heat pump <br /> Urinal UnR heater <br /> DNnking Fountoin Ooilcr <br /> _ Floor drain Refigeration <br /> Gr�ease trap Woodstove <br /> � Roof tlraine — pWa <br /> � Other — <br /> qtY OF LVERETT LOCAL SALES TAl(CODE IS]105 <br /> i nereDy cenury Nat I nave reaC ana examinCC this appliCation and Imow the same to be true and correct. Afl provisions of laws ard <br /> ordinaces goveming this type of wnrk Hnll be complied with whether spedfied herein or noL The granting of a pertnit does not presume <br /> to givp auU�ority to violate or cancel the provision of any other state or local law regulating consWct;pn or tne performance of <br /> wnswaon.rnet i am aumorized�y�he owner ot this property ro pertortn he wcrK for wnicn apuucation u made and i comp�y v.om tne <br /> St3t9 tra�tors L RCW and 289200 WAC. <br /> � �/ � � Q <br /> ignature o nC.onVactor/Au(npnzgtl AgBtlt Date <br />