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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER'VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 42.`r257-8857 —wvn�v.everettv,�a.org <br /> APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM / Z--�� _��3 <br /> SITE ADDRESS PARCEL TAX I.D. # PERh11T p <br /> 2723 RIVERVIEW BLVD 00603700009100 M�312- b2�}- <br /> LECv1L LOT ND. BLOCH TRACT <br /> DESC � <br /> OWNER ADDRESS aNRip PHONE <br /> �'ALLY A RICHARDS 2723 RIVERVIEW BLVD 98023 425-750-7391 <br /> TENANT NAME CONTACT FOR PERRt1T PHONE <br /> Jennifer Covello 206-774-9499 <br /> CONTRACTOR �/�/ESCO ADDRESS dN21P PMONE I <br /> VV 3909 196 St SW, LYnmvood 98036 800-398-4663 <br /> CONTR. LICENSE� WAS H I ES971 OB <br /> I <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK � <br /> RES _E�ectr.c � Gas_other 950.00 <br /> WORI( DESCRIPTION � <br /> REPLACE 50 GAL GAS WATER f-IEATER <br /> PLUMBING MEGHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 7otlet P1C —air handP,nc un�t; <br /> _ �aU�tub Forced au systems <br /> _ Lavatory (�,�ash basin) Gas piping <br /> Shower i V.�aien c�ater <br /> Krtchen sink& msposal Gas fucolacc <br /> _ O�sh�tiasher Gas range <br /> _ Clolhesv�sher Clothesdryer <br /> _ Laundry iray Range hood <br /> _ Smk (service/baUmop/elc ) Eshaust lan <br /> 6ackllow preventcr Heat pump <br /> Unnal Umt heater <br /> Drmhing Fountain Boder <br /> _ Floor tlrain He�ngeralion <br /> _ Grcase trap Woodstwc <br /> Koof tlrams Other <br /> O;hci --- <br /> CIN OF EVERETT LOCAL SALES TA7(CODE IS J105 <br /> 1 hereby cerr,ity that I have read ond eKamined this apphwhon and Anow the same to be �me and correct All prv�isions ot laws and <br /> ordinaces governmg �his type ot�w�A vnll be comphetl ���h whether spealied herein or not. The giantmg ol a perma does not presume <br /> to gwe authonry to violate or cancel the provision ot any other state or lo�al law regulaGng mnstrucUon or the peAormance ot <br /> conslructwn. Thot I am au�honzea by the owner of Ihis property to perlorm the �wrh lor whKh apphcalion is matle antl I mmply wRh Uie <br /> State Contractors Law 18 27 RCOV antl 296 200 WAC <br /> c�,p�.�y„��n,r.����e��9n� <br /> J e n n i fe r B u�e s s ,,,,�,��.��,�e�„�..�..,��„�,.,,,,�w�,.:� ,�x„�,.., <br /> f[fYn,email.�ndlnp-.T�mM1.cm:-�'t <br /> Signatu�e of OwneUConlracto AulhOnC2tlX 2tl ' "' "�� Dale <br />