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( <br /> PERMIT APPLICATION ,�S�i <br /> CITY OF EVERETT PERMIT SERVICES N <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT M <br /> 1531 Rockefeller Ave 00438230301400 '� p (' C'1 <br /> LEGAL LOTNO. BLOCH TRACT <br /> DESC. nur.inivtu�totsts6ia gLK 303 D•00 EVERETT DIV N P�AT <br /> OWNER ADDRESS CfiYIZIP PMONE <br /> Dick Barker 1531 Rockefeller Ave everen se2o� 425-344-9194 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> IMelissa Croda 360-945-2787 <br /> CONTRACTOR WESCO ADDRESS CITY2IP PHONE <br /> 2800 Thorndyke SEATTLE 206-378-6649 <br /> CONTR.LICENSE#W AS H I ES.77 1 OB <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR I _Eloctric ✓ Gas_O�hor 750.00 <br /> WORK DESCRIPTION <br /> Replace 40 gallon gas to gas water heater <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilot _ A/C–air handling units <br /> Bathtub __ Fcrced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower + Water hoater <br /> Kitchen sink&disposal _ Gas freplace <br /> Dishwasher _ Gas range <br /> Clothes washcr _ Clothes dryer <br /> Laundry trey _ Range hood <br /> Sink(service/badmop/etc.) _ Exhausl(an <br /> Back(low provontor _ Heat pump <br /> Urinal _ Unit heater �I <br /> Dnnking Fountain _ 6oiler <br /> Floor drain _ Refrigeralion �li <br /> Groase trep _ Woodslovn I <br /> Roo(drains _ Other i <br /> Olher — <br /> CITY Of-EVERETT LOCAL SALES TlU(CODE IS 3705 <br /> I hereby contify ihal I have read and exominod lhis applicalion and know tho same to bo Irue and correct. All provisions of laws and <br /> ordinaces goveming this rypo of work will be compliod wilh whether specified herein or noL The granting of a permit does not presume <br /> to give authority!o vinlato or cancol tho provision of any other state or local law regulating construction or the performance of <br /> consiruction.That I em authorized by Iho owner of this proporty lo perfortn the�eork tor which applicalion is made and 1 comply with the <br /> Slale Contractors Law 1827 RCW and 29�.200 WAC. <br /> 'f' � / �'�1 <br /> % �/�".,6'G�"�G' <br /> Signature of OwnedGon raclod�uthorized Agenl � ale <br />