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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 425-257-6857—www.everethva.org <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �` �G� .�I� <br /> SITE ADDRESS PARCEL TAX I.D.!1 PERMIT N <br /> 614 WARREN AVE 0056�g0130�800 /�/1 Q� � b�j� <br /> LEG4L LOT NO. BLOCH TRACT <br /> DESC <br /> OWNER ADDRE55 ❑TVRIP PHONE <br /> BOB TEMPLETON 614 WARREN AVE Everel19B201 425-347-5282 <br /> TENANT NAME CONTACT FOR PERAIIT PHONE <br /> Af�1BER RAY 612-644-6463 Jennifer Burgess 206-774-9499 <br /> CONTRACTOR \�lESCO ADORESS QN21P PHONE <br /> VV 3909 196 St SW, Lynnwoatl 9803fi $00-398-4663 <br /> CONTR.IICENSEt� WASHIES97106 <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Residential _e�e�c��� �Gas_Other I $850.00 <br /> WORK DESCRIPTION <br /> Replace 50 gal gas water heater TANK IS LOCATED IN THE BP.SFh�ENT <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITE67 NO. NPE OF FIXi URE OR ITEh9 <br /> Toilet A/C—air handlmg unds <br /> Bathtub Forced air systems <br /> Lavatory (wash Uasin) _ Gas pipmg <br /> Shower i Water heater <br /> Kdchen sink 8 tlisposal Gas lueplace <br /> Dishwasher Gasrange <br /> Clothes�vasher Clolhe5 dryer <br /> L�undry tray _ Range hootl <br /> Smk (serv�ce/baUmop/elc) _ Exhaust fan <br /> �achflow preventer lieat�ump <br /> Urinal Unit heater <br /> Dnnhing Fountam 6oiler <br /> Floor Arain (2eingeration <br /> i 3rease Irap Wootlstovc <br /> Rool drains OIhCt _ <br /> Other <br /> CIT'OF EVER[TT LOCAL SALES TAX CODE IS J705 <br /> I hereby centity that I have read and exammed lhis apphcauon antl hnow tlie same to Ue true and correcL All prrnisions of laws and <br /> ordmaces governing thistype of work w�li be mmphetl w�th whether speuhetl herein oi no[ The qranting of a permd does not presume <br /> to grve authonty to violate or cancel the provision of any o„�er state or lotal law regulating construction or the peAormance of <br /> construdion. That I am 3uthonzed by the owner of ihis property to perform the work lor which application is made antl 1 comply with the <br /> Siate Contradors Law 18 27 RCW and 296 200 WAC <br /> Ci;i�.uy nc��o ny:r�xn Bm�re+� <br /> Je n n ife r Bu rq e ss �„«:��,nr��,9�,.�_„�,,,,�ur2a..�,o, ��a,�,..�„ <br /> CUW R.�rnail+I�"nllnfnwpnmlt[nrq[AS <br /> SignatureolOwneUContrecto Authonzad�, �n "" � ' Ua[e <br />