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, <br /> PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-2ti7-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �z����� <br /> SITE ADDRESS PARCEL TAX I.D.8 PERMIT S <br /> 1108 Rucker Ave oo4ses22so2�oo ,vl G�i �.-o_ y <br /> LEGAI lOTNO. BLOCK TRACi <br /> oesc. LOTs 21 8� 22 BLK 223 D-oo HEIGHTS ADD TO EVERETT <br /> OWNER ADDRESS CITYIZIP PHONE � <br /> Randy Bonsen 1108 Rucker Ave Everett 98201 425-259-6628 <br /> TENANT NAME GONTACT FOR PERMIT PHONE <br /> Melissa Croda 360-945-2787 <br /> CONTRACTOR 1�fESCO AODRE55 CITY2IP PHONE <br /> �� 2800 Thorndyke SEATTLE 206-378-6649 <br /> CONTR.LICENSEfI WASHIES971OB <br /> USE OF BUILDING HEAT SOIiRCE CONTRACT PRICE OF WORK <br /> SFR _Eleclric � Gas_Other 95�.0� <br /> WORK DESCRIPTION <br /> Replace �as to gas 50 galion water heater <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYpE OF FIXTURE OR REM <br /> Toilel A/C—uir handling units <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower + Woler heater <br /> Kilclien sink 8 disposal Gas fireplace <br /> Dish�vasher Gas rango <br /> _ Ctolhes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/elC.) Exhaust(an <br /> Backflow prevenler Heal pump <br /> Urinal Unit healer <br /> Drinking Founlain Boiler <br /> Floor drain Re(rigeration <br /> Grcaso trap Woadstovo <br /> Roof drains Other <br /> Other <br /> CIN OF EVERE7T LOCAL SALES TA7(CODE IS 3105 <br /> I hereby ceritify Ihat I have read and examined this application and know Iha same to be irue and conect.�I All provisions o(laws and <br /> ordinaces�oveming this type of work will be complied wilh whether specifcu herein or not.The granling of a permit does nol presume <br /> to give authoriry to violate or cancol Iho provision ot any olher stale or local law regulating construclion or tho performance of <br /> construclioa That I am authorized by the owner of this property to pertorm ihe work for which applicatlon Is made and I comply with tho <br /> State Contractors Law 1/8.27 R�C `a 96.200 WAC. <br /> i��i `--�"��s� // <br /> . .�.0 � /a %� oG <br /> Si�g�a l�uro of Ownor/, ractor/Authonzed Agenl Dale <br />