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� � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evereMrva.orp <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �a.��-lZ <br /> SITE ADDRE88 PARCEL TAx I.D.M PERMIT• <br /> 1614 CHESTNUT ST o0619732602400 208 ��52 <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER � E98 ON21P MONE <br /> TROY D HINES 1614 CHESTNUT ST Everetl9B2G1 425-772-7213 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> IJennifer Burgess 206-774-9499 <br /> CONTRACTOR �AlESCO �RE88 aN21P PMONE <br /> �� .1 3909 196 St SVV� Lynnwood 98038 80o-:;�e-4663 <br /> CONTR.LICENBEM WASHIES97 I OB <br /> USE Of BUILDING HEAT 80URCE CONTRACT PRICE OF WORK <br /> SFf� I _E�ecthc �,Gas_other $950.00 <br /> WORK DESCRIPTION I <br /> Replace 50 gal gas water heater I <br /> PLUMB NO MECHAN CAL I <br /> N0. TVPE Of FIXTURE OR ITEM NO. TVPE OF fl%TURE OR ITEM <br /> Tollet A1C—alr handiing units <br /> Bathtub Forced alr systems <br /> Lavatory(wash basin) Gas plping <br /> Shov.er � Water heater <br /> Kttchen slnk 8 dlsposal Gas fireplace <br /> Dlshwasher Gas ranfle <br /> Clothea washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Slnk(eervke/bar/mop/etc.) _ Euhauatfan <br /> Backflowpreventer _ Heatpump <br /> Urinal _ Untt heater <br /> _ Orinking Fountaln Boller <br /> Floor draln Reirlgeretbn <br /> Greaee trap Woodstwa <br /> Roo}tlralns Other <br /> Other <br /> qT/OP EVERETT LOCAL BALEB TAX COOE 18 7105 <br /> I hereby cerRlfy that I have read and axamined thle eppllcatlon and krawthe aame to be true end correct. All prablona of laws and <br /> ordlnacee prnerning thls type of worK will be complled wlth whether spxlfbd hareln or not.The prendng of a perrtYt doea not presuma <br /> to pive authorlty to vlolete or cancel the prrnlsion of any other atata cr local law repulating mnatruclion or the peAormance of <br /> construcllon. Thet I em euthorl:ed by the owner of thle proparty to pMorm the work for which eppllcatlon la made end I complywith the <br /> Slate Contractore law 18.27 RCW entl 296.200 WAC. <br /> Jennifer Burqess ��"��� <br /> pl.cnlrmfn luY�0.a.N01111 MIf 5i RIiMt.w.Idl I1M'!S� <br /> VINNI.�mw�ilnF�F�^�an�.US <br /> b pnature o er oMrac ut oTa � e.e <br />