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� �— — <br /> - - —s <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —ewJw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERAIIT# <br /> 1613 EDGEMOOR LN oo�a0a00000300 IVll�j�s-03� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DtSC <br /> OWNER ADDRESS QTV�ZIP PHONE <br /> KAREN DAVIS 1613 EDGEN100R LN E��erett98zo� 425-355-3006 <br /> TEt�ANT NAf�1E CONTHCT FOR PER1.71T PHONE <br /> Jennifer Burgess 206-774-9499 <br /> COtJTRACTOR 1A/ESCO ADDRESS QN/ZIP PHONE <br /> ,�V 3909 196 St SW, �Y^^����d yeU�� 800-398-4663 <br /> CONTR. LICENSE a WASHIES971 OB � <br /> i <br /> � <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORF( <br /> Residential _e�e����� �c35_o�he� 950 <br /> WORK DESCRIPTION <br /> REPLACE 50 GAL GAS WATER HEATER <br /> PLUMBING MECHANICAL II <br /> NO. TYPE OF FIXTURE OR ITEi�1 NO. TYPE OF FIXTURE OR ITEL7 <br /> Todet AIC–airhantlling units <br /> Bath[ub Forcetl air systems <br /> Lavatory (wash bas�n) Gas piping <br /> Shower + Water heater <br /> Kitchen sink& tlisposal Gas tireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Laundry tray Range ha�d <br /> Sink (scrvicc/baUmopletc J [zhaust fan <br /> Backflow prevenler Hcat pump ; <br /> Urmal Und hcater <br /> Dnnking Fountain � Boiler <br /> Floor drain ReftigeraGon <br /> Gre�sc Vap Woodstove <br /> = Root Orains -- — I = Olher <br /> Othcr <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby cerR�ty that 1 have reatl and examinetl thls applica!ion antl know the same to be true antl correct All prwisions of laws and <br /> ortlinaces goveming this type ol vrork vnll be comp:ietl wdh whether spealied nerem or not. The grant�ng ot a permR tloes not presume <br /> to gwe authonry to violate or cancel the provision of any other state or lowl iaw regulatmg constructlon or the pedormance ol <br /> constructwn That I am authonzed by the owner ol this pro�- ty to perform Ihe v.oik for which application is matle antl I comoly wdh Ihe <br /> State Contractors Law 182' RCLV and 29620D WAC <br /> C�;iivry tld��M ey Iv'��dn Bw,nt <br /> Jennifer Bur�ess ��,«:���,�d�,s..�o.�,��M«n«�..�,.,�.��,,.:.t„ <br /> ttFY�,�m+u ymwto�m.onmi�am�-�s I <br /> Signature of OwneVConlracto Authorratl� n -' � Date <br /> --- - - - _l <br />