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PERMIT ApPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8310 — F�X 425-25?-8857 — wvw�.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM g„'�7--�Z <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />1209 W MUKILTEO BLVD 00505�00001602 �(ZO$ '(�SD <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS pT'21P PHONE <br />MICHAEL K DAVIES 1209 W MUKILTEO BLVD Everett98^<03 425-239-9034 <br />TEIJANT NAME <br />CONTRACTOR �VESCO <br />CONTR.LICENSE#�AIASHIES9! �OB <br />VV <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />Replace 40 Gal gas water heater <br />NO. � TYPEOF FIXTUPE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor Arain <br />Grease Irap <br />Roof drains <br />Other <br />ICONTACT FOR PERMIT <br />Jennifer Burgess <br />ADDRESS <br />3909 196 St SW, <br />HEATSOURCE <br />_ Electric � Gas_ Other <br />PHONE <br />206-774-9499 <br />pTY21P PHONE <br />�ynnwood sttoss 800-398-4663 <br />CONTRACT PRICE OF WORK <br />$750 <br />NO. I TYPEOFFIXTUREORITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />8oiler <br />Refrigeration <br />Woodstrne <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct All prwisions of laws and <br />ordinaces goveming this type ot work will Ue mmplied wth whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel lhe provision of any other state or local law regulaling construction or the pertormance of <br />construction. That I am authorized by the owner of ihis property to perform the work for v.mich appiication is made and I comply with the <br />State Contractors Law 18.27 RCW 0nd 296�200 W AC�.mn�u�omun� <br />J e n n ife r B u rq ess °«u.��,.��„�:�-��°°�9��� m�� ���m����s,�,.��_,��,�..t5, <br />