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06-13-'08 11:28 FROM- T-640 P002/003 F-111 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE[T, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br /> SIT[ADDRESS PARC[L TAX I.D.If PERMI7 R � <br /> � 1711 RUCKER AVE 00438034500500 j��' �(-,�- - ,� / <br /> LEGAL LOTNO. BLOCIC 7ftl�CT <br /> D@SC <br /> OWNER AOORESS CIN/ZIP PNONE <br /> DAWN SITTAIIER 1711 RUCKER AVE, Everett 98201 425 745-1700 _ <br /> TENANT NAM11G I GONTACT FOR PERMtT ❑Ii�NE <br /> Naida Khan/Norihwest Permit Inc 360-945-2787 <br /> CON7H4CiOR \A/ESCO ADDRE55 CITVI2IP PHONE <br /> VY <br /> CONTRLICENS[/ WASHIES97106 2800 Thorndyke Ave W seattie,981�J9 206-378-6649 <br /> USE OP BUILDING I ti[AT SOURCE I CONTRAC7 PRICE OF WORK <br /> Residential �E��n�+� X Gae_Ou�e� $950.00 <br /> WORK DESCRIPTION <br /> Rep�acing 1 gas to gas 50 gallon water heater <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF fIXTURE OR IT[M NO. TYPE OF FI%iURE OR ITEM <br /> Toilel NC—air handling unils <br /> Balhtub Forced air systems <br /> lavalory(wash basin) Gas p�ping <br /> Shuwer ' Water heatar <br /> Kitchen sink&dlspo5al _ Gas fireplace <br /> � Oishwasher _ G2s range <br /> Ciothos washer Clolhes dryer <br /> T Laundry tray _ Range hood <br /> Sink(sorvice�badmapletc) _ Exhaust fan <br /> � �ackflaw preventer _ Heal pump <br /> Urinai Unit heater <br /> _ DrinAing Fountain � Bo�ler <br /> Floor drain ReMgeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> O�her <br /> CIN OF EVERETT LOCAL SALEu TAX CODE IS]705 <br /> I h�reby coriUfy that I have read 2nd Cxamined IhiS apphcalion antl know the 52me to be t�ue and CorreU. All proviSions 0��aurs and <br /> ard�naces governln�th�s rype of work will 6e complied w�th wtiether speci6ed herein or not The grantinc�of a perm�t does not presume <br /> to give authonty to violate or cancel the pmvision of any othar state or local Iaw regulalinp construcdon or the pahormance of <br /> ccnstmdion That I am authonzed by the owner of this propeiry to pertorm the work for which applicabon is made and I wmply wdh lhe <br /> Slate Co ractors Law 18 7� CW and 296 200 WAC. <br /> ��l0 15 �� <br /> Signature o .vnenGcc r/Authonzed Agent at <br />