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__ -� - — - - _--_� <br /> PERMIT APPLICATION � <br /> CITY OF EVERETT PEaMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857 — w�vN.everetRva.org <br /> i <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS I PARCEL TAX I.D.# PERP,71T # <br /> 1320 HOYT AVE � 00�3852aao220o <br /> ---�---- �'0 ���_ <br /> lFC'J•1 LO7 NO �LOCK T TRACT <br /> GESC i i I <br /> OWNER ADDRESS CIN21P PHONE <br /> JEFF RIFE 1320 HOYTAVE Evere�t9e2ot 425-231-9219 <br /> TEIlAtJT NAidE CONTACT FOR PERtAIT PHONE <br /> IJennifer Burgess 206-774-9499 <br /> CONTRACTOR � � AD�RE55 QN21P PHONE <br /> WESCO 3909 196 St SW, 500-398-4663 <br /> Lynnv:oo:1 580,36 <br /> CONTR. LICENSE h W��HI ES971 OB <br /> USE OF BUILDING � HEAT SOURCE i COIJTRACT PRICE OF WORK <br /> Residential � __�E����� 1/. �as_c;�,e� I $750 <br /> WORK DESCRIPTION <br /> REPLACE 40Gl1LLON GAS 1N/1TER HEATFR <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIX7URE OR ITEfd NO. 7YPE OF F�,xTURE OR ITELI <br /> To�ict WC —au handl�ng unds � <br /> _ BdfhtU� FOfCBtl 3R Sy5[Btf15 I <br /> Lavatory (vrash basn) Gas pipmg <br /> Snowm � Water hester - <br /> riilchen sinh E tlisposal Gas fiteplace <br /> Disnwasher Gas range � <br /> Clothes washer Clothes tlryer <br /> , Launtlry Iray Rangc hwtl <br /> _ Sink (,ervicel6ar/mop/elc J Exhaust lan I <br /> _ Backllow preventer Heat pump <br /> Unnal Unil heater <br /> Dnnkino Fountain Boder <br /> Fioor tlrain RelrigeraUon <br /> __ Grcase trap Wootlstovc <br /> Ro01 drains OUiCr <br /> _ Other <br /> CITV OF EVERETT LOCAL SALES TA7(CODE IS 3105 <br /> I I�ereby cerrtrfy ihal I have reatl and examined Ihis application �nU knowthe Sdme to b2 Vue and correcl All provisions of laws antl i <br /> o�d�naces goveming th�stype ol work will be rnmphetl��th whe:her speulietl herem or not The grantmg ot a permrt tloes not presume <br /> 10 grve authoriry to v�oiale or cancel the provis�on of any other state or local iaw regulahng cnnstruction or the pertormance of ; <br /> ccnstruction. That I am authonzetl by the o�vner of this property to pertorm the work for whrch apphcation is made a�d I compty with Uie i <br /> State CoNractors Law �B 27 RCbV ana ?96�00 WAC <br /> r.�-n,rr�ne�m r.v,,.��,u�,e���a�.� <br /> J e n n ife r B u rc�es_s �.,:,�:..,.,�R,,.: ���_,�Rr,�.,�,,,iaw,,�.,_,�,.,::�s, <br /> 4'fM'R imyi.�nmi•n�iawTarMt<oTtUS <br /> ��grature or��.vr,e�IConiracFc�iAuthon�n l�gen � ' - Date � <br />