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12-15-'J9 13:7.5 FFOf1-na� permit 1J6G9952091 T-9s7 POG�il�l�3 F-C?5 <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT RERMI'T SERVICES <br /> 32G0 CEDAR S7REET, EVERETT, lNn 98201 ' <br /> 425-257-8810 - FAX 425-257-H857 -v�n'nv.everethva.org <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��..—��� —�_ <br /> SITE AODRESS PARCEL TA%I.D.p PERMfT k I <br /> 3012 K.ROMERAVE 00437572G00300 ��� �L1/`�� ��G` <br /> LEGAI LOT NO. BLOCK TPACT <br /> 0@SC. <br /> OWNER AOURESS CITY/ZIP PHONE <br /> LYLE BLANK same as site address ever s8205 425 353-0500 <br /> TENANT NAME CONTACT FOR PERMIT PIiONE <br /> Naida Khan/Cyndal Millhollin 360-945-2787 <br /> CONiRaGTOR \�/ESCO AODRLSS CITY2iV PHOHE <br /> �� 2800 Tl�orndyke SEATTLE S00•398-4663 <br /> coNTa.�i��Nsea WASHIE59710[3 <br /> USE OF BUILDING HEAT SOURCE COM RACT PRIC[OF WORK I <br /> residential _E��d��� �[cas_omer $750.00 <br /> WORK�ESCRIPTION <br /> replace gas 40 �allon hot waler heater <br /> PLUMf31NG MECHANICAL <br /> NO. riP[OF fIXTURC UN ItEM NO. NPE OF FUITURE OR ITEId <br /> Toilel NC—a�r hanclliny un�,Is <br /> ealhlub Porced air syslems <br /> Lavatory(wash basln) ^ Gas piping <br /> Shower + Waler healer <br /> Kdchon sink&disposal _ Gas fireplace <br /> � Dishwasher Gas range <br /> � Gothus washcr Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(servicelbar/mop/etc.) Exhaust tan <br /> ` Oackflow preventer Meal pump <br /> Urinal Und hcaler <br /> � Dr�nking Fountain _ Boiier <br /> Floor drain Refnr�eration <br /> Grea,e�rap _ woodslove <br /> Roof tlrains Olher <br /> Other � _ <br /> i — -- <br /> �� CITY OF EVERETi�OcnL SnLES TAX CODE IS 3�05 _ <br /> II he�eby centdy that I have read and exam�ned thls applicalion and knaw the same to 6e Uue antl correc. All previsions of ia�+s and i <br /> '� ord�naces governu�p Vus type of work vnll be cornpiied��th wrether speafied hercin or not. Thr,giantine, o�a perm��does not presume I <br /> i ro c�ivp authonty to violate or cancei the prows�on ol any ether state or locdl isw regulating cunstruct�on or the pertormance of <br /> � censtructioa That�am au�honzed dy the owne� ef tn�s Gropmty to perlorm�he work(or wliich applicalion is made and I compry v�lh thc <br /> Stata Con�raclors La(�d.27 RGW and 2962C0 WAC. <br /> c� <br /> � ��v�"s�_c�,�,�_ � �-( c�-( c'- 1 <br /> � Sgnature 01 Own uniractOdAu�honzed Agenl Date <br />