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_ �— __ _•— — <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — vnvw.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />2105 NiCDOUGALL AVE #2 <br />LEC �L LOT I10. BLOCV <br />D r I <br />THOMAS J FLAKE <br />TEIJANT tJAf:tE <br />CONTRACTOR \A/ESCO <br />vv <br />CONTR. LICENSE a� nIASHIES9/ I OB <br />VV <br />USE OF BUILDIIlG <br />res <br />PARCE�TAXI.D.# <br />00401544100300_ <br />TRACl <br />PERMIT tt <br />_�d_(���>oZ <br />AODRESS pTV2�P PHONE <br />2105 ��4CDOUGALL AVE #2 Ev=rett 9�20� 425-34�-954G <br />CONTACT FOR PERLIIT � PHOWE <br />Jennifer Burgess 206-774-9499 <br />ADORESS qTY'ZIP PHONE <br />3909 196 St SW, �>""r0otl 9e0�' 800-39�3-4663 <br />HEATSOURCE <br />_ Elec;ric � Gas _ O�rer <br />\NORI< DESCRIPTION <br />REPLACE 40 GALI.Oi� GAS WATER HEATER <br />NO. ' TVPEOFFIXTUREORITE�d <br />'cil�; <br />L'a;hiub <br />Lavatory (wash basin) <br />Showc� <br />Kilchen sinh E disposal <br />D�sh�vasner <br />Clolhes washer <br />__ Laundry lray <br />_ Sink (serv�ceiUaumopletc ) <br />Bactillow prnventer <br />Urin, I <br />Dnnhinq Fountain <br />Floof drain <br />Grcasetrap <br />Itoct d�ams <br />_ Other _ _ <br />CONTRACT PRICE OF WORV< <br />750.00 <br />NItGFiHIVII.HL <br />NO. I NPEOFFIXTUREORITELI <br />A/C - a�. ^and6no c- t<. <br />FOfCed 2�It Sy5IW�1S <br />Gas Fip�,ng <br />i Water heater <br />Gas lueplacc <br />Gas ranqc <br />Clothes dryer <br />_ R�ngchootl <br />Exhausl tan <br />___ Heatpump <br />_ Und neater <br />Hoiler <br />_ Refngero4on <br />WOOUSfove <br />Othet <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereUy cent�ly thal 1 have reatl and eaam�ned this apphcaUon and hnow the same to be Irue anA conect nn �ro��s�o�s o� iaws a�,a <br />ordmaces governing tn�s type of worF: wnl be comphed ��ih whethet specrtietl herem or not The grantinc� ot a permd tloes not presume <br />to grve authonry to violate or cancel the provision o� any other s�ate or locai iaw regidaUng mnstruttion or ine pertormance of <br />construtlion That i am authonzetl Cy the owner ol Ih�s property to perform the wvrk lor vmKn apphcation �s maae and I comply wdh the <br />St�te Contractors L��v �R 27 RCW ar•d 2?6 200 WAC <br />p� �iu:p uJnc Cs :^rnlln Pury�n <br />J e n n i f e r B u r� e s s,,, :,�:�.,..:�, a�,�.,, �_�,_,wrK,�„ ,,,,,,�, �,, .��,,,,,,,, <br />fI1J.'ll. �m)e-4-�r'bq:.�n9na.�•r.: T r.lp <br />S�gnature of OvmertGo�tracto Autho�i�rd h� etl -'� '���—� Date <br />