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C ( , <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.everetlwa.org <br /> APPUCATIONS ARE ACCEPTED FROIN 8 AM TO 4 PM � �� ,,,0+� <br /> l <br /> $ITE ADDRE83 PARCEL TAX I.D.N pERIMT� ' f <br /> 2702 Forest View Drive ooso37o0r,tsloo I � �O l ' �i3 <br /> LE LOTNO. BLOCK TRACT <br /> oesc. LOT 161 BLK 000 D-00 VALLEY VIEW <br /> OWNER R SS CITY/aP PHONE <br /> Nancy Aceto 2702 Forest View Drive everan ae2os 425=513-9986 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Melissa Croda 360-945-2787 <br /> conrn�crae WESCO ��Eaa cmmP PHorre <br /> CONTR.LJCENBEA 2800 Thorndyke SEATTLE 206-378-6649 <br /> WASHIES971 OB <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WOFqC <br /> SFR _e�ectr�c ✓ c88_on,er I 4578.00 <br /> WORK DESCRIPTION <br /> Install Montigo gas fireplace insert model # DHSN <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR REM NO. TYPE OF FOfTURE OR ITEM <br /> Tollet A/C—eir handling unks <br /> Bathtub Forced eir syatems <br /> Lavatory(wash basln) Gea piping <br /> Shawer Water heater <br /> Kitchen sink&disposal i Ges flreplece <br /> Dishwa �er Ges range <br /> Clothes washer Cbthes dryer <br /> Laundry tray Range hood <br /> Sink(servicelbar/mop/etc.) Exheust fan <br /> Bedcflow preventer Heat pump <br /> Udnal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain ReMgeration <br /> Grease tiap Woodstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALEB TAX CODE 19 J70S <br /> I hereby ceritify that I have read and examined lh(s applicetion and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified hereln or not.The grenting ot a pertnil does not presume <br /> to giva authority to violate or cancel the provision of any other state or local law regula8ng construdion or the performance of <br /> conslruction.That 1 am authorized by the owner ot this properry to perfortn the work for whidi epplfcadon is made and I comply with the <br /> State Contracto�s Law 18.27 RCW and 296.200 WAC. <br /> y ��nre�� _ /���7- - <br /> Signature of O ontractor/ ulhoriz gent ate <br />