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— -- � <br /> PERNEIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR .`',TREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425257-8857—�vvrr�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE55 PARCEL TAX I.D.# I PE�<MIT# C� � <br /> 1211 Hoyt Ave ooao942280�000 � ''�1 � �C�G'�� <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 QTi/ZIP PHONE <br /> Cathy Elkington 1211 Hoyi Ave Everett 98201 4254180740 <br /> TENANT��AME CONTACT FOR PERMIT PHONE <br /> Jennifer Burgess 206-774-9499 <br /> CONTRACTOR \A/�SCO ADORE55 qTV21P PHONE <br /> �� 3909 196 St SW� Lynnwoocl seosa 800-398-4663 <br /> CONTR.LICENSE#,^/AS H I ES9/ I OB <br /> vv <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> RES I _Elec[ric �Gas_Other $g50 <br /> WORK DESCRIPTION <br /> REPLACE 50 GAL GAS WATER HEATER <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> � Toilet _ A/C–airhandhng units <br /> Bathtub _ Forced air systems <br /> Lavatory(v�ash basin) _ Gas piping <br /> Shower i Water hea[et <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer _ Clothes dryer <br /> Laundry tray _ Rar�ge hood <br /> Sink(service/bar/mopletc.) _ Exhaustfan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit hea[er <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> ROOf drainS Oth?t <br /> Other — <br /> CIN OF EVERETT LOCAL SA�ES TAX CODE IS 3105 <br /> I hereUy ceritify that I have read and examined this application and know Ihe same to be true and correct. All prwisions of laws antl <br /> ordinaces governing thistype of work will be complied with whether,pecified herein or not.The granting of a permit does not presume <br /> to give author�.ty to violate or cancel the provision of any olher state or local law regulating oonslmction or the pertormarce oi <br /> construction. That 1 am authorized by the owner of this property to perlorm the work for whkh application i�made and i comply wdh the <br /> State Contractors La�.v 1827 RGW and 296.200 WAG. <br /> 1�,��I�.Jry JBnm W Irvmlln Bw9nf <br /> - Jennifer Bur ess ��"���r��,.��awqesto.nonnerrzsrrtxvrt,��=�ur�un•ns� <br /> A <br /> L I IW(I.ttnall.�mnllnpawyemh[urt�[�US <br /> Signature of Ov+nerlConvacto Authcrcatl � en ' � - ' Date <br /> __J <br />