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f � <br /> PERMIT A,PPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S _(� �-I2 <br /> S�TE ADDRESS PARCEL TAX�.D.M PERMIT N <br /> 4633 MERMONT DR o0407801506700 �� <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS Q7Y21P PHONE <br /> 00407801506700 same as site address 98203 425-259-3834 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> ICyndal/Naida 360-945-2787 <br /> CONTRACTOR \AIESCO �DRESS QTYGIP PHONE <br /> VY 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSE M N�ASH I ESg7 1 OB <br /> USE OF BUILDING HEAT SOURCE CONTRACT PR�CE OF WORK <br /> residential _e�e�t�� �Gas_Other '��jQ.QQ <br /> WORK DESCRIPTION <br /> REPLACE 40 GALLON HOT WATER HEATER <br /> PLUMBINCi MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tollet A/C—alr handling units <br /> 8athtub Forced alr systems <br /> Lavatory(vrash basin) Gas piping <br /> Shower � Water heater <br /> Kftchen sink 8 dlsposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/badmop/etc.) _ Exhaustfan <br /> Backflowpreventer _ Heatpump <br /> Urinal Untt heater <br /> Drinking Fountaln Boiler <br /> Floor drain Refrigeration <br /> Greasetrap _ Woodstwe <br /> Roof drains Other <br /> Other <br /> dTV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerKity that I have read and examined this application and krwwthe same to be true and correct. All prwisions of Iaws and <br /> ordinaces governing thistype oi wurk will be comptletl with whether spectfied hereln or not.The granting of a perrNt does not presume <br /> to give authority to violate or cancel the provisfon of any other state w local law regulating oonstruction or the pertormance of <br /> construdion.That 1 am authorized by the owner of this property to pertorm the work for which application is made antl I comply wdh the <br /> State C>6t�ractors Law 19.27 RCW and 296.200 WAC. <br /> .,C���-� 5/17/12 <br /> ignature o nerl ontractor/ uthorizetl c�ent ate <br /> I — <br />