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PERMIT APrLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM g —Q% �_ t <br />SITE ADDRESS PARCEL TAX I.D. N 1 PERMIT <br />2405 HILLSIDE LN 00567900400405 <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />CHARLENE CLEMENTSON <br />2405 HILLSIDE LN <br />Everett98203 425-353-6979 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />(Jennifer Burgess 206-774-9499 <br />CONTRACTOR WESCO <br />CONTR. LICENSE M WASHIES971 OB <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />Replace 50 Gal gas water heater <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilei <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />_ Kitchen sink & disposal <br />_ Dishwasher <br />_ Clothes washer <br />_ Laundry tray <br />_ Sink (service/bar/mop/etc.) <br />_ Backflow preventer <br />_ Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />_ Grease trap <br />Roof drains <br />Other <br />ADDRESS <br />2800 Thorndyke <br />HEATSOURCE <br />_ Electric 1/_ Gas _ Other <br />CITYIZIP PHONE <br />SEATTLE 800-398-4663 <br />CONTRACT PRICE OF WORK <br />$950 <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ A/C —air handling units <br />_ Forced air systems <br />Gas piping <br />r Water heater <br />_ Gas fireplace <br />_ Gas range <br />_ Clothes dryer <br />_ Range hood <br />_ Exhaust tan <br />_ Heat pump <br />_ Unit heater <br />_ Boiler <br />_ Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />D .*dgN M k.wOfn 8u 1 <br />gAlr <br />Jennifer Burgess DN«A.J am <br />pr, (w,Y.jmNln�mM<^ nU5 <br />