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-- - - -- -� <br />� <br />PE�2M1T APPLIC�lTION <br />CITY OF EVERETT PERMIT SERVICES <br />3200CEDAR STREET,EVERETT.Wr+S8201 <br />42�-25i-ft810 - FAx 425-257-6857 - wvrw eve'ettwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� SITE ADORESS <br />6�5 L�UREL DR <br />i P�rL LO7 NO. <br />i.ESC � _ <br />�rJILLIAM S CHURCH <br />TENANTNAME <br />COtJTFACTOR `/�,ESCO <br />�v <br />CONTR. LICENSEx WASHIES971 OB <br />USE OF BUILDING <br />RESIDEUTIAL <br />PARCELTAXI.D.# <br />00562000000100 <br />TRACT <br />615 LAURFL DR <br />CONTAC7 FOR PER�AIT <br />IJENNIFER COV�! L <br />ADDRE55 <br />3909 196th St SW <br />HEATSOURCE <br />._ Elecmc � Gas __ Oihe� <br />VJORK DESCRIPTION <br />REPLACE 50 GnL GAS WATER f iEATER <br />PLUMP:NG <br />NO. T�PE OF FIXTURE OR ITEM <br />-- To�iet - — <br />8dthtub <br />_ Lavatory (wash basin) <br />ShOw2r <br />Kdchen ,ink 8 tlispos�N <br />D�snwasher <br />Gothes washer <br />Laundry tray <br />Smk (;ervicelbar/mop'etc ) <br />paCkNow prevenler <br />Urinal <br />_ Drinhing Founta��n <br />Floor dran <br />Gre:� se lrap <br />Roo( drains <br />Olhc� ------- <br />t"IIV� <br />EvereU 98201 4�5-299-4344 <br />PNONE <br />p 206-774-9499 <br />CITY/21P PHONE <br />Lynnwood 8a0-398-4663 <br />I CONTRACT PRICE OF WORK <br />950.00 <br />NO. i TYPE OF ^x7URE OR ITE1d <br />.JC – a�r handhng un�ts <br />Forcetl au systems <br />Gas p�pmg <br />� Water heater <br />_ Gas fireplace <br />Gas range <br />_ � Clothes d�ye� <br />Range hoed <br />Eah�usll�n <br />Heat pump <br />..--- Unil heater <br />Bcder <br />� _ Refngeranon <br />Woodstove <br />Other <br />x <br />CITY OF EVEHETT LOCAL SA1 ES TAX CODE IS J705 _,__ _ <br />I nereby cerdify Ihal I have reatl and examined this apC���bon and knuw the same lo he true and correct All provi;ions of laws and <br />ordinaces govem�ng this type of work will be complied w�ih whelher speci6ed herein or not The granlmg ol a permd tloes not presum� <br />�o grve authonty to violate or cancel the prov�sion of any other slate or local law regulaUng construchen or the pertormance o( <br />-: cnsUuct�en That I am authonzed by Ihe owner of this property to pertorm the work (o: which application is maae and I comply w•rth 7he <br />�tate Contractors La�.v 78 27 RGV� a�d 29G.?.QQ,al,V(,�E�,,,.,,,,c,,:,. <br />Jennifer Covello �;� �.��,�,�o,.�o,_,:�,�..,,�„m,,.,.,., <br />-.ml.� n.M1�=:�am -'�5 <br />n��:� �n�.��.a <br />S�gnatuie of OwneUConYaclodAuthoriied Agent Date <br />