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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 —ww�.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �{ � a,� •..-1 3 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT # <br /> 2705 RIVERVIEW BLVD o0603700009300 �ti� / 3b�1 —Q5 � <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC <br /> OWNER ADDRESS dN21P PHONE <br /> BRYAN E BROCKMqN 2705 RIVERVIEW BLVD Fvereu9E1203 425-297-3971 <br /> TENANT NAME CONTACT fOR PERIAIT PHOt�E <br /> Jennifer Burgess 206-774-9499 <br /> CONTRACTOR AD�RESS pNRIP PHONE <br /> WESCO 3909 196 St SW� '-ynnwood 9803G g00-398-4663 <br /> CONTR. LICENSE N`^rASHI ES97� OE <br /> VV <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Residential I _Eiectnc �.Gas_other I $950 <br /> WORK DESCRIPTION <br /> RFPI_ACE 50GAL GAS WATER HEA' . I <br /> I/1NK IS LOCA7[D IN [iASEM[NT <br /> PLUMBING MECHANICAL <br /> IJO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITE�A <br /> Toilet NC –au handling unds <br /> BatntuU Forcetl air systems <br /> Wvalory (wash basin) Gas piping <br /> ShoWer � Water heater <br /> K�tchen sink E tlisposal Gas lireplace <br /> Dishviashcr Gas range <br /> Clolhcs washcr GoUies tlrycr <br /> Launtlry lmy Range hood <br /> Smh (servicelbar/rnoplelc) ._ Exhaus;fan <br /> _ f3ackllow prevenler _ Heat p�.imp <br /> Uimal Und hcater <br /> piuiFing Fountaio . Liodcr <br /> Floor nrain Retrigeration <br /> Grease Irap Woodstovc <br /> ftoot drains other <br /> Other — �--- ...— <br /> � CITV OF EVERETT LOCAI SALES T/�X CODE IS 3105 <br /> I hcrcUy ceritdy that I havc rcatl antl czaminetl Ihis apphcatwn and hnow Ihc samc to bc true and wrrccl All provisions ol law;antl <br /> ordinaces�oveming ihis lype ot work vnll be complied v�nth wheU�er specdietl herein or not f he granlin9 ot a permd Aoes not presurne <br /> lo grve authordy to violate or cancel the provision of any other state or local law re�ulaUn� mnstrurtion or tne pedonnance ol <br /> construction. That I am authon_eA by the owner of this property to perform the work for vniich apphcation �s m�tle antl I comply�•nih Ihe <br /> State Contrectors L aw 18 ?7 RCW and 236 200 WAC <br /> flq�.v/JgnM IH InmlLr Ilw�n\ <br /> J e n n i f e r B u r e s s ,:,,,,, ,.�,,,,.�,,,�,,..,,,,,,w„�.:,,,„a..�,.��.,�„�,�.,,, <br /> �'i W.•n.r�..nb 4.�.��InU,�«r•rmi�.mm r V5 <br /> Signature o1 qwiieNContraclo- �uUionz�tl /iJen ���""'"'�"'�'— Uate � <br />