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SITE ADDRE55 <br />825 Rucker Ave <br />LeCriL LOT NO. <br />ULSC I <br />JACKLUTEN <br />TENANT NAhiE <br />CONTRACTOR �A/ESCO <br />VV <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — �+nv�,v.everethva.arg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCH <br />CONTR. LICENSE N WASHIES971 OB <br />USE OF BUILDING <br />RES <br />WORK DESCRIPTION <br />RFPLACE ELEC WATER HFATER <br />NO. I NPE OF FIXTURE OR ITEM11 <br />Toilet <br />Balhtub <br />Wvatory (�ash basin) <br />Shower <br />_ Kdchen sinA 8 disposal <br />Dish�tashcr <br />Clothes �tiasher <br />_ Laundry Uay <br />_ S�nh (scrv�cc/bar/mopletc.) <br />_ RachHow preveNer <br />Unnal <br />Drinhing PounWm <br />Floor drain <br />Grease trap <br />HOoI tlrams <br />� O(hCr LlrclntWalnNedlCr <br />PARCEL TAX LD. # <br />00553216901300 <br />iRACT <br />ADDRE55 <br />825 Rucker Ave <br />CONTACTFJRPERMI� <br />Jennifer Burqess <br />A�DRE55 <br />3909 196 St SW, <br />HEATSOURCE <br />� Elettrit _ Gas_ Other <br />�'i - ��-I <br />PERMIT q <br />-Ol5 <br />Everett9820� 4252590107 <br />PHONE <br />206-774-9499 <br />dTV21P PNONE <br />Lynnwoc+d 98036 g00-398-4663 <br />CO��TRACT PRICE OF WORK <br />$1312.00 <br />NO. � NPE OF FIXTURE OR ITEfr1 <br />rUc - air nandi�ng unrts <br />Forcea ar sys;ems <br />Gas p�ping <br />Watcn c�atcr <br />Gas !ucplxe <br />Gas rangc <br />Clothes drper <br />Range Pood <br />Ezhaustfan <br />Ileit pump <br />Vn�t hcater <br />8otlei <br />Reingerauon <br />Wootlstwc <br />Other___ _ <br />q7Y OF EVERETT LOCAL SALES TAX COOE IS 1105 <br />1 hcreby centify that I have read antl eaammed this application and hnow Ihe same to bc lruc and conect. All prv.�islons ot laws and <br />oitlinaces govermng tnistype ot Horh w�ll bc Complietl w�ih whether spetihrtl herein or not The granhng ot a permit doe5 not presume <br />to grve authonty to v�olate or cancel �he provision ot any othet state or local law regulating mnsVuction or the peAormance ot <br />conslruction That I am aulhon_ed by the owner of lhis property lo perlorm the wnrA lor �N�[h apphcaLon is matle antl I cpmp!y wRh U�e <br />State Contractors Law 18 27 RCW antl 296 200 YJAC <br />��4r.�N �:�2+n� �mmn eur,m <br />Jennifer Buraess cHnr�r��+ne,,.G.na.r�onir�.•.r�rteuu.u�,uwn�pv <br />ClNA:I, ImYI.�w�nAf�thMqmm[mT � -U5 <br />