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�.. c �..ve . or v mo�.�.o...u� oa.nrv.m icamr) �nooa000�oo r.o...� o�,i.o�..n _:n�..��. <br />PERMIT APf�LICATION <br />CI'fY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — �niww.everetlwa.org <br />SITE ADDRESS <br />1410 MADRONA AVE <br />DESC <br />EDWARD LARSON <br />TENANTNAME <br />APPLICATIONS AR� ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />00505700002302 <br />BLOCK I TRACT <br />CONTRACTOR IA/ESCO <br />VV <br />COHTR.LICENSE#��/ASHIESJ! IOB <br />VV <br />USE OF BUILDING � <br />RESIDENTIAL <br />WORK OESCRIPTION <br />�(--I �t�/ <br />PERMIT # <br />�Y� i y0`E-DD� <br />1410 MADRONA AVE Evere�t 98?03 425-232-3202 <br />CONTACT FOR PERMIT PHONE <br />JENNIFER COVELLO 206-774-9499 <br />ADDRESS CITYIZIP PHONE <br />3909 196th St SW Lynnwood 800-398-4663 <br />HEATSOURCE <br />_ [ledric 7� Gas � Other <br />REPLACE 50 GAL GAS WATER HEATER <br />:[.� <br />Il�l,'d:7C[r <br />TYPE OF FIXTL'RE OR ITEM <br />Todet <br />�athtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 Cisposal <br />Dishwasher <br />Clothes washer <br />l.aundry tray <br />Sink (sorvice/bar/mup/etc.) <br />Back(low preventer <br />Urinal <br />Dnn'r.ing Fountain <br />floor drain <br />Grease Imp <br />Roo( drains <br />Other _ <br />CONTRACT PRICE OF WORK <br />950.00 <br />N0. I TYPE OF FI%TURE O� �TEM <br />lu':; — air handiing unils <br />Forced air systems <br />Gas piping <br />+ Water hzater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />_ Range hood <br />[xhaust (an <br />Fleat pump <br />Unit heatcr <br />Boiler <br />_ Refrigcra6on <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS ]705 <br />I hereby centify that I have read and examined this application and know thc same lo be Irue and �.orted. 1111 prowsion, of law, and <br />ordinaces goveming Ihis type of work vnll be cornplied wilh whelher specified herein or not The gi�.�finy of a permit does noi presume <br />to give a�thority to vlolatc or cancel Ihe provision of any other state or lowl law regulating wnstruction or the perlormance of <br />construction. That I am authoiized by the owner ol thi ; property lo periorm ihe work for which application is made and I compiy with ihe <br />Stat2 Conlractors Law 16.27 RCW and 29�,?�QA,�,�,�'y � , <br />J e n n if r "' m":.o�'°.� <br />e Covello o��,_A.�,�,<a..��,.�.,,..�,..�„�,,���,���. <br />�Tmul•r�rila�Fn..inn� �n. V3 <br />