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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 425-257-8857—www.eveiettv✓a.org <br /> APPUCATIONS AR= ACCEPTED FROM 8 AM TO 4 PM ���, �—��— <br /> SITE AODRESS PARCEL TAX I.D. # PERMIT il <br /> 1331 RUCKER AVE oon38s2nao�soo _ <br /> LEGAL LOT NO. BLOCH TRACT <br /> DESC <br /> OWNER ADDRE55 QT'21P PHONE <br /> BQB 8 LARRAINE DIETEL 1331 RUCKER AVE Everen9020t 425-750-0116 <br /> TEN/VJT NAME CONTACT FOR PERMIT PHONE <br /> Jennifer Burgess 206-774-9499 <br /> ---�����-(—�,c�--- <br /> CON?RACTOR ,� ADDRE55 aN?oo y�o,6 Pg00-398-4663 <br /> 3909 195 St SW, <br /> CONTR. LICENSE N WASHIES971 OB <br /> USE OF BUII.DING HEAT SOURCE I CONiRACT PRICE OF WORK <br /> / I <br /> Residential _e�e�«�� y Gas_Other � 8490.00 <br /> WORK DESCRIPTION <br /> INSTALL OIL TO GAS FURNACE WITH 30' NFW GnS PIPING AND FLFC TO G/1S <br /> Wl1TGR HEAIL=R WITH 20' NEW GnS PIPING <br /> PLUMBING MECHANIGAL <br /> NO. T'PE OF FIXTURE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> ��— � lbdet —. . ���-_ � ��—_ �/C-ar handlina um�s �� � --��-- <br /> BaIhWU � I-orCr.d au sysipms <br /> L.vatory (wash basm) 2 Gas piping <br /> Snower + Waten c�ater <br /> Kitchen sinY.E AiSposal Gas Oreplace <br /> D�shwasher _ Gas rangc <br /> Gothes washer Clothcs dryer <br /> Laundry iray Rangc hopd <br /> SmY. (service/baUmop/Mc) _ Erhaus�lan <br /> _ Gacknow preventer __ Heat pump <br /> Urinol UnR heatc� <br /> Urmking 1 u��,ntam Boder <br /> __ Flooi d�ain Reln9erahon <br /> Grcise irap Woodslwc <br /> Rooi dia�ns Olher <br /> Othcr — � �-- -�— <br /> -- ---- - -�- -- --- - -- '— - —- <br /> C1iY Of EVER[TT LOC/1L SA�ES TA%CODE IS 3105 <br /> I hr�cby renldy Ihat 1 have iead anA erammed Ihis app6ca�ion and D.nowthe 5ame to be true and corrrcl All pra�ision5 0�IavS and <br /> olduiaces r3overcing thistype ol wolk will be fompl�ed with whr�her speClhed herem or not The grantlnG pt a permR does not pfe5ume <br /> to grve aulhoriry�o violate or r.ancel the provision ol any pther state or local law reguiatmy mnsiruttion or Ihe pedormance of <br /> construdion l hat I am authon:�d by the owner of this property to perform the work tor which apphcation i, mad_o and I comply wdh the <br /> Statv Gontractors Law 18 77 Rr_�n/antl J36 200 WAG <br /> �n:p�.n�no^���•�n.,�no-nemro. <br /> J e n n ife r B u r e s s �,,,.�.,.m,��,,,,.,.� „-M,,,:;..�,,,,w�,.�„ ,r.,,,,,�,,,, <br /> 1'I Wlll.�.n..�il �mnil�rin��T•.rml.inr.�r.11: <br /> C,i7naluic ot OwneNContracto Authcn,ed QJei��W'�rn""M��—Dale— <br />