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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S�REET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.K PERMIT• <br /> 2117 WETMORE AVE 00439143600900 'c�.Oa'�� <br /> LEG4L LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS QTV21P PHONE <br /> RITA HOOPER same as site address 98208 425-252-2204 <br /> TE�:ANTNAME CONTACTfORPERMIT PMONE <br /> Cyndal/Naida 360-945-2787 <br /> CONTRACTOR \A/ESCO ADDRESS tlTV21P PHONE <br /> �� ff-7 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSEIl�A�ASHIES.7l �OB <br /> VV <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> residential _e�e�c��� �Gas_other 950.00 <br /> WORK DESCRIPTION <br /> REPLACE GAS 50 GALLON HOT WATER HEATER <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> Toile[ A1C—air handling units <br /> Bathtub Forced alr systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower i Waier heater <br /> Kftchen slnk 8 disposal Gas tireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/badmop/etcJ F.zhaustf�n <br /> Backflow preventer Heat pump <br /> Urinal Untt heater <br /> Drinking Fountain Boilef <br /> Floor drain Refrigeration <br /> Grease trap WooCstwe <br /> Roof drains Other <br /> Other <br /> qN OF EVERETT LOCAL SALES TIV(CODE IS 3105 <br /> I hereby certtify that I have read and examined this application and knov+the same to be true and correct. All prwisions of laws and <br /> ordinaces goveming thistype of work will be complietl with whether specifietl herein or not.The granting of a permit does not presume <br /> to give authoriry to violate or cancel the provision of any other state or local law regulating mnstruction or the peRormance of <br /> construction. That I am authorized by the owner of this property to pertorm the v,rork tor whkh application is made and I mmply wtth the <br /> State Contrectors Law 1b27 RCW antl 296.200 WAC. <br /> T-�-.-=_. 2/6/12 <br /> Signature of OwneUContractorlAuthorized Agent ate <br />