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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—wv�nv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �J �-JO —I 2 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 2119 FULTON ST 00516444700900 �ZO —�� � <br /> LE:aAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER A�DRE55 dTY21P PHONE <br /> VICKI HOWELL 2119 FULTON ST Everett se2o1 425-344-0101 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> INaida Khan 425-346-2188 <br /> CONTRACTOR \�/ESCO ADDRESS pT'21P PHONE <br /> �� 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSF.#�n IAS H I ES 97�O B <br /> vv <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> SFR I _Electric �Gas_Other <br /> WORK DESCRIPTION <br /> REPLACE 50 GAL GAS WATFR HEATER. <br /> — PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ aC—air handling units <br /> Bathtub _ Forced air systems <br /> Lavatory (wash basin) _ Gas pi�ing <br /> Shower � Water heater <br /> Kitchen sink 8 disposal _ Gas tireptace <br /> Dishvrasher _ Gas range <br /> Clotheswasher _ Clothesdryer <br /> Laundry trey _ Range hood <br /> Sink(service/bar/mop/etc.) _ Eahaustfan <br /> Backtlowpreventer _ Heatpump <br /> Urinal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Greasetrep _ Woodstove <br /> Roof dreins Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritity that I have read and examined this application and knowthe same to be true and correct. All prwislons of laws and <br /> ordinaces goveming thls type of work will be mmplied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of anq other state or local law regulating construction or the peRormance of <br /> constructioa That I am authorized by the ovmer of this property to perform the wrork for whkh application is made and I mmply with the <br /> Siate Contractors Law 18.27 RCW and 296200 WAC. <br /> uo„�„�;.,�d u.,.n,�,.tv�n.�, <br /> Jennifer Burgess m���mn�w6urqmo=hL`PIIMIIi1SIlVli.w+NW11ORii <br /> M RVII.ev�i.l��nlnEnwpvmt�m�aU5 <br /> Signature of OwnerlGontrectorlAuthonzetl Agent Date <br />