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� � <br /> PERMIT �PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-885�—www.everettwa.org <br /> APPLICqTIONS ARE qCGEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE35 PARCEL TAX I.D.tJ PERMIT <br /> 191GRo�kefellerAve 00437038002500 �� _�<'/ <br /> IEGA lOTNO. BLOCK TRACT � <br /> DESC. <br /> ��E� AODRESS CITY21p PNONE <br /> Davld Zanziq 1916 Rockefeller Ave Everott 98201 206-786-1948 <br /> 7ENANT NnME CONTACT FOR^[RMIT PNONE <br /> INaida Khan 3G0-945-2787 <br /> CONTRqCTOR �nI�SCO hDDRES3 CITYiZIP PNONE <br /> CONiR�ICENSE! 2800 Thorndyke SEATTLE 800-398-4463 <br /> WASHIES971 OB <br /> USE OF BUIL�ING I HEAr soURCE CONTFtACT PRICE OF WORK <br /> SFR `eie«,;� �Gas,Other I � '��� <br /> WORK DE4�RIPTION <br /> REPLA,CE 50 GALLON GAS WATER HEATER <br /> PLUMBiNG MECHANI AL <br /> NO. TYPC•OF fIxTURE OR ITFM N0. TYPE OF flXTURE OR ITEM <br /> _ 7onet _ A/C—airhandlingunits <br /> a Bathtub Fora:d air systems <br /> _ lavatory(wash basin) <br /> ` Shovrer _ Gas piping <br /> + Weterheater <br /> _ Kitchen sink 8 dispasai ` Gas fireplace <br /> _ �ishwasher ^ Gas range <br /> , Cioihns washer _ ClO�hes Gryef <br /> _ Laundry tray _ Range hood <br /> � Sink(s�rvicalbadmop/elc.) Exhaust fan <br /> _ BaCkflow preVenter , lieet pump <br /> _ Unnal Unit heater <br /> _ Drinking Fountain Boile� <br /> Floo�drain � Reirigar,tion <br /> _ urease trnp ` Woodstove <br /> Roofdrains , Other <br /> ' Other <br /> CI7Y OF EiERlTi LOCAL SALES T/1x CODE IS 3105 <br /> I hereby ceri�ify that I have read and exomined lhis eppticafion and know the same to be true and cortect fUl provisions of I�w:and <br /> ardinpces goveming lhis tyDe of�vork w�ll he compliw.t with whother epecified hemin or not The yranliny�f a permll tloes not pre5um0 <br /> to give authority to violate or canael the provisian of any other stale or local law tegulating�onstruqion or the performance of <br /> construciion. Th�t I am authorized by ihe mvner o!this property(o perTorm th¢work for which appllcalion is made an� ,comply with the <br /> State Contradors La��1 2)R �2g6.200 WAQ � Z <br /> Signeture oi OwneuContra r/ utnorized Agent � . / <br /> � <br />