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/ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> • 25-257-8810— FAX 425-257-8857—www.everettvva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a/a-a'�� <br /> SITE ADORESS PARCEL TAX I.D.M PERMIT• <br /> 1110 CASCADE DR o039360040040� 1 OZ- �3g <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC <br /> OWNER AD�RESS QTY21P PHONE <br /> GERARD 8 LAUREL DAHLIN same as site address 98203 425-353-4516 <br /> TENANT NAME CONTACT FOR PERMIT PMONE <br /> Cyndal/Naida 360-945-2787 <br /> CONTRACTOR \A/ESCO ADDRESS QTV21P PHONE <br /> �" 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSE M WAS H I ES97� O B <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> residential I _Electric �Gas_Other ]QQ5.7] <br /> WORK DESCRIPTION <br /> REPLACE ELEC 10KW AND 3 TON HEAT PUMP <br /> PLUMBINa MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tollet A/C—alr hanuung unita <br /> Bathtub + Forced alr systems <br /> Levatory(vrash basin) _ Gas piping <br /> Showar Water healer <br /> Kttchen sink 8 disposal Gas ilreplaca <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Laundry tray _ Range hootl <br /> Sink(servicelbadmopletc.) Exhaust fan <br /> Backflow prevanter i Heat pump <br /> Urinal UnR heater <br /> Drinking Fountaln _ Boller <br /> Floor draln Relrlgeration <br /> Greaee trap Woodstwe <br /> Roof tlrelns Other _ <br /> Other <br /> qTV OF EVEREtt LOCAL SAlEB T/U(CODE IS J105 <br /> I heieby certlity that I hava read end examined this applicatlon antl knowthe same ta be true and corroct. All prwislona of lawe end <br /> ordlnaces goverNng this type of work will be mmplietl wlth whether specifiatl hareln or not.The grentinp oi a perrNt doea not presume <br /> ro giva authority to vlolate or cancel the provision of any other stata or locat law regulating wnstruction or the peAormanca of <br /> construction. That I em authorized by tha owner of thi�proparty to pertorm the work for whkh eppllcatlon Is matle and I comply wtth the <br /> State Contractors Law 18 27 RCW and 296200 WAC. <br /> Y-::-, 2/21/12 <br /> S gnature o wner ororactor u or ze gen a e <br />