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PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org
<br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��_r�3 _���
<br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT#
<br /> 1531 ROCKEFELLER AVE o043823030�400 �l�-_ 0�5
<br /> LEGAL LOT NO. BLOCK TRACT
<br /> DESC
<br /> OWNER ADORE55 QTY21P PHONE
<br /> DICK BARKER 1531 ROCKEFELLER AVE e�eren sa2oi 306-435-8999
<br /> TENANT NAME CONTACT FOR PERMIT PHONE
<br /> SIERRA ZWEIG 206-550-0890 Jennifer Burgess 206-774-9499
<br /> CONTRACTOR \A/ESCO ADDRESS ❑T'fZIP PHONE
<br /> VV 3909 19G St SW� lYnnH�oad 9803fi $00-39B-4663
<br /> CONTR.LICENSE H`^I^�u I CS97� Op
<br /> vvr� i i � u
<br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK
<br /> Residential _e���t��� �Gas_Other $750
<br /> WORI( DESCRIPTION
<br /> Replace 40 gal gas water heater
<br /> PLUMBING MECHANICAL
<br /> NO. TYPE OF FIXT�IRE OR ITEM N0. TYPE OF FIXTURE OR ITEM
<br /> Toilet A/C-air handlmg units
<br /> BatMuU Porced au syslems
<br /> Lavatory (wash basin) Gas p�pmg
<br /> Showcr i Water ncater
<br /> hRchen 5ink 8 disposal Gas lueplace
<br /> Dishvnsher Gasrange
<br /> Ciothes�vasher Clothes dryer
<br /> I.aundry iray R.�yc liood
<br /> Sinh (scrvice/barlmop/etc ) _ Exhaust fan
<br /> f3ack11owpreveNer _ Hcatpump
<br /> Vnnal Und heater
<br /> Dnnkmg Founlam _ L'oder
<br /> Ploor Arain � ReingeraUon
<br /> Grcasc trap � Woodslwe
<br /> Root drains ' Olher
<br /> Other — ..----
<br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105
<br /> I hereby cerddy that I havc rcad and ezamined thi;apphcation and know the same to bc Iruc and correcl All prwisions ol Wws and
<br /> ordinaces govemmg this type oi�wrk v+ill be complied v.ath whetner specdied nmem or not The giantmg ol a permd does not presume
<br /> to�rve authonty lo violate oi cancel Ihe prov�sion ol any other state or local law regulating construction or Ihe pertormance of
<br /> consUuction -1 hat I am authon�ed by ihe owner ot this propeity to perform Uie work lor whKh apphcahon is matle and I compty wrth Uic
<br /> State Contractors Law 78.27 RCW antl 236 200 WAC
<br /> l;��1:11I Y'Jnl111/ITI'.Ilr�Mli��lll
<br /> Jennifer Bur�ess ,,,.,, ,�,,.��,,.�.�,.,.,,n,,,,,,�„„aw,,.,,,,_,,.,,,�,,,,
<br /> ����,�,.�,.,�.,.,,�,�.�„nm,,.�m�.�,
<br /> r e�m���m++---
<br /> Signawrc ot Owner/Gontracto Aulhonu��F,� �'� Date
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