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f <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA �8201 <br /> 425-257-8810— FAX 425-257-8857—vw✓vv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � `a�-�13 <br /> SITE ADDRESS PARCEL TAX I.D.# � PERMIT# <br /> 4326 RIDGEMONT DR 00555600002�0o I Jl,� (�D ( " U�� <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC <br /> ON/NER AOORE55 pN21P PHONE <br /> JAPviES ILES 4326 RIDGEMONT DR Evereu982o3 425-501-4251 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Jennifer Burgess 206-774-9499 <br /> CONTRACTOR A�DRESS pTY21P PfiONE <br /> WESCO 3909 19G St SW, Lynnwood 9NO3fi g00-398-4663 <br /> CONTR. LICENSE#�A,ASHI ES971 OB <br /> VV <br /> USE OF BUILDING HEAT SOURCE CONTRACT PkICE OF WORK <br /> Residential I �Electric �Gas_C' ler $950.00 <br /> WORK DESCRIPTION <br /> REPLACE 50 GAL GAS WATER HEATER <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C—airhandlingunds <br /> Bathtub _ Forced air systems <br /> �avatory (v.ash basin) _ Gas piping <br /> Shower i Water heater <br /> Kitchen sinh& tlisposal _ Gas fireplace <br /> Dishwasher _ Gas ran9e <br /> Clothes washer Clothes dryer <br /> Laurdry hay _ Range hood <br /> Sink (service/badmop/etc.) _ Exhaustfan <br />� _ Backflow preventer _ Heat pump <br /> Urinal Unrt heater <br /> Dnnkmg Fountaln _ Boiler <br /> Floor drain Refrigeratio� <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TFJ:CODE IS 3105 <br /> I hereby cenUfy that I have reatl and exam ned this apphcalion and hnowthe same to be true and correct. All pra�isions of IaHs and <br /> ordinaces governing Ihistype of work Nnll Ue complied with whetlier specified herein or not The granhng of a permit does not presume <br /> to give authority to vlolate or cancel the p�rvision ot any other state or local law regulating mnstruchon or the pertormance ot <br /> construction That I am authorized Uy the owner oF this property to perform the worh for whkh application is made and I mmply wdh the <br /> State Contractors La�v 18 27 RCW and 296i400 WACv � ��InPurgns <br /> J e n n ife r B u rq e s s fAlmJerv.YnBurgn;a=MJF11ff.151111:M1'I� ru tCFlllid5l <br /> fl W.'II.ttnail��n•nIln�MwPnml:.[�T['US <br /> Signature of Owner/Contracio A�rthoricad � n ' -�"� � ""� ��� Date <br />