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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.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �2�.g—Q�p <br /> SITE ADDRESS PARCEL TFJC I.D.M PERMIT p <br /> 2122 Rucker Ave 00439143202100 ,,c�� � } t��. <br /> LEGA LOT NO. BLOCK TFiACT <br /> DESC. <br /> OWNER AD�RESS CINlLIP PHONE <br /> Brandon Drake 2122 Rucker Ave, Everett 98201 425-268-7627 i <br /> TENANT NAME I CONTAGT FOR PERMIT PHONE �i <br /> Melissa CrodalNorthwesl Permit Inc 360-945-2787 <br /> CONTRACTOR wESCO ADDRES3 CITY2IP PHONE �I <br /> CONTR.UCEN9E� wASHIES9710B 2800 Thorndyke Ave W seatcio, 98199 206-378-66�9 �� <br /> USE OF BUILDING � HEAT 30URCE CONTRACT PRICE OF WORK <br /> Commercial F.lectnc x Gas_Other $4,250.00 <br /> WORK DESCRIPTION <br /> Replace a gas to gas commercial water heater - Model # G75-125 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower � W2ter heater <br /> Kitchen sink 8 disposal Gas 6replace <br /> _ Dishwasher Ges rangc <br /> � Cbthes washer Clothes dryer <br /> Laundry tray Range hood <br /> �, Sink(service/bar/mopletc) Exhaust fan <br /> � Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain � Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstave <br /> Roof drains Other <br /> Other <br /> C�TY OF EVERETT LOCAL SALES TAX CODE IS�f05 <br /> 1 hereby centify thal I have read and examined Ihis application and know the same to be true and corred. All provisions of laws ond <br /> ordinaces goveming this type of work will be ccmplied wilh whether specifed herein or not.The granting of a permit does not presume <br /> to give aulhonty to violate or cancel the provision of any other state or local la�v regulatmg construdion or the periormance of <br /> construction.That I am aulhorized by lhe o�mer of this property to pe�torm the work for which application is made and I compiy H�th the <br /> Slale Contractors La�v 1827 RCW and 296.200 WAC. <br /> T /�,ue� /-��7� <br /> Signalure of O�medContractodAuthonzed Agenl ate' <br />