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PERMIT APPLICATION 3��� � <br /> CITY OF EVERETT PERMIT SERVICES �� �a <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> S�7E ADDRESS PARCEL TAX I.D.# PERMIT N <br /> 2901 Everett Ave 2so52000aoszoo I �,�Dl 01� - C�a� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DES^. <br /> OWhER ADORESS CITY2IP PHONE <br /> EvelynStellwagen 2901 EverettAve everense2o� 425-252-1197 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> IMeiissa Croda 360-945-2787 <br /> CONTRACTOR IA/ESCO ADDRESS CITY2�P PFiONE <br /> V11 2800 Thorndyke SEATTLE 206-378-6649 <br /> CONTR.LICENSEB WASHIES971 OB <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � �nJn1�/�/ Electric ✓ Gas Other <br /> — — 3000.00 <br /> WORK DESCRIPTION <br /> Replace G82-156 Commercial Waier Heater <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIXTURE OR I7EM N0. TYPE OF FI%TURE OR ITEM <br /> _ Toilet A/C—airhandlingunits <br /> _ Bathtub Forced air syslems <br /> _ Lavatory(wash basin) Gas i in <br /> �n' � <br /> __ Shower + Woterhealer <br /> _ Kitchen sink&disposal Gas freplac� <br /> Dishwasher — <br /> _ Clothoswasher „a�,o� <br /> _ Laundry tray _„nge hood <br /> _ Sink(service/bar/mopletc.) Exhausl fan <br /> _ Backllow proventer Heat pump <br /> _ Urinal Unit heater � � <br /> Drinking Fountain Boiler <br /> _ Floor dmin Relrigeration <br /> Greaso irap Woodslova <br /> Roo(drains Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby ceritify lhat I have read and examined Ihis application and know Ihe same to 6a true and correcL All provisions of laws and <br /> ordinaces governing lhis lype of work wiil bo complied with whethor speci�ed herein or not.The grant�ng o(a permil doas nol presumo <br /> to give authority to violato or cancol the provisioo of any other state or local law regulating constmclion or Ihe periormanco of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> � � • /j / <br /> ,� • �,.Gl�lf,�L �� q/(� <br /> Signawro of OnneqConhactor/ ut onzed Agent Date <br />