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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—ww�v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a —.�c�—��j <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT f1 <br /> 1822 CHESTNUT ST 00563235602500 �'i,1 (�>G,i=��' �_ <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC <br /> OWNER ADDRE55 CITV2IP PHONE <br /> DAVE MADLE 1822 CHESTNUT ST Everett ee2ot <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CHERI L CARLSON HOME: 425-220•1319 Jennifer Burgess 206-774-9499 <br /> CONTRACTOR 1A/ESCO ADDRE55 dTV21P PNONE <br /> �� 3909 196 St SW, Lynnwood 9H03Fi $00-398-4663 <br /> CONTR. LICENSE M,^,AS H I ES97�OB <br /> YV <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Residential _E��«<�� �Gas_Other $950 <br /> WORK DESCRIPTION <br /> Installt�as fireplace-with-i0'gas-pipiAg <br /> �li(��L� �Cof.C4 �1Gf'�l�C� u,��n��— �. � ]r'iio�. �C� I'�[tr.�i'>> <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> Tollet _ A/C—air handling unrts <br /> Bathtub _ Forced air systems <br /> Lavatory (wash Uasin) _ Gas piping <br /> Shower i Water heater <br /> Kltchen sink 3 disposal _ Gas lirepl2ce <br /> Dishvrasher _ Gas renge <br /> Clolhes washer _ Cbthes tlryer <br /> Laundry vay _ Range hood <br /> Sink(service/bar/mopF>tc ) _ Exhaust fan <br /> Bachflow preventei _ Heat pump <br /> Unnal __ UnR heatef <br /> Drmking FounWm _ Boder <br /> Floor Arein Refrigeration <br /> Grease trap _ Woodstwe <br /> Roof Arains _ Other <br /> I _ Other _ — — <br />� CITV OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cerrtify that I have read antl eKaminea!his apphcation antl know the same to be true and correct All prwiswns ol laws and <br /> ordinnces governing thistype of worh vnll be mmplied wnih whether specihed herein or not The granting of a permit does not presume <br /> to grve authonty to vwlate or cancei the provision of any �.aher state or local law regWating a�nstruction or the pertormance ol <br /> construaion That I am authoncetl by the ovmer ot this property to perform the vrorh lor vM�c��i apphcation is matle and I comply wRh the <br /> State Coniractors Law 18 27 RCW and 296 400 WACry ^•, „x .y� <br /> Jennifer Bur�ess �,, ,..k,.,,.�.w��,:� ,,.�,,,�,,,,H,.�� .,,.,�..,,,,..,.� <br /> 11 Wlll�ma�b�nmMnfa,+�,nmL.nim rUt <br /> Synature o OwneUContracto Authorl�ad n <br /> ."^«"""^'— ate <br />