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01-21-'09 12:52 FROM- T-248 P004/095 F-998 <br /> — � �. <br /> PERMIT APPLICATION <br /> CITY OF EVERETl' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8657—www.everettwa.org ( <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEI TAX i.o.q PERMir# <br /> 1415 RGCKEFELLER AVE ooa75429000700 �f 0' j — � <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC <br /> OWNER ADDRESS CITY2IP PHONE <br /> ROBIN JORGENSEN 1415 ROCKEFELLER AVE EVERE1T,98201 425-259-3A23 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Naida Khan 360-945-�787 <br /> CONTRACTOR �n/ESCO AODRESS cliv/11P PHONE <br /> VV 2800 Thorndyke SEATTLE 206-378-6649 <br /> °oNT".u�ENSEs WASHIES971 OB <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR I _E�edric �Gas_other J 950.00 <br /> WORK DE3GRIPTION <br /> REPLACING A GAS TO GAS 50 GALLON WATER HEATER <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXiURE OR ITEM <br /> Toilal AIC—air handlinp unita <br /> Bethtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower i Water heater <br /> � Kilchen sink&disposul Gas fireplecc <br /> Dish.vasher Gas range <br /> � Clolhes wnsner Clothes dryer <br /> Laundry trey � Ranga h�od <br /> Sink(seraiceJbar/mop/etc.) Euhaust tan <br /> fl2ck�ow provenler J Meat pump <br /> Urinal Umt healer <br /> Dnnking Fountain Boiler <br /> Floor drain Rcfngeration <br /> Grease trap � VJootlstove <br /> Roof drains Olher <br /> i _ Other _ <br /> I <br /> � Clrv OF EVERETT LOCAL SA�ES TIU(CODE IS 7105 <br /> i nereby ceritiy thst I h2ve read 2nd examined Ihis apP�i�ation and knowthe same to be lrue and co�rect. All pravisions of lews and <br /> ordinaces c�overning lhis type of�+�ork will be complied vnth whelher speufed herein ar not. The granling of a permit does not presume <br /> ta yive authoriry to violate or c2ncel the provision of any otner slate or local law reflulaling wnslruction or the periormance of <br /> consWclion. That I am aufhorized by the owner o(this property to per�orm the wvr'�.for wl�ich 2pplica�ion is made and I comply with the <br /> State Contraaors Law 18.7.7 RC/�W and 296.200 WAC. <br /> l .Ul� � IZ � � � <br /> S�gnature uf"�wn ne o r or Futhonzea A{�enl ate <br />