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01-07—'09 12:07 FROM— T-297 P002/004 F-998 <br /> � � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810– FAX 425•257-8657–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM � — �'S —�� <br /> . SITE AOURESS PARCEL TAX I.D.M PEKMI R <br /> 3109 SHORE AVE 00571700900200 'G/ —/� <br /> LEGAL LOTNO. �LOCK TiUCT <br /> DESC. <br /> . OWNER ADORE55 CITYI2IP VHONE <br /> JEANETTE HEARD 3109 SHORE AVE EVERETT,sesoa 425-743-9839 <br /> TEN�NT NAM[ CpNT�CT FOR PERMIY PHONE <br /> INaida Khan 360-945-2787 <br /> CONTRACTOR \A/ESCO ADDRESS CITYIZIP PMONE <br /> �� C .1 2800 Thorndyke SEATTLE 2os-378-6649 <br /> I CONTR.LICENSE���fASHIGS971OB <br /> YY <br /> ; USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR I _Elednc �Gas,Olher I 950.00 <br /> � WORK DESCRIPTION <br /> REPLACING A GAS TO GAS 50 GAILON WAT[R HEATER <br /> PLUMBING MECHANICAL <br /> NO, ttPE OF PIXTUIIE OR ITEM NO. IYPE OF F�7IiuRE OR ITEM <br /> Toilot A/C—air handling unils <br /> Bathtub Forcetl air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower i Waler heal�r <br /> Kitchon sink&Oisposal Gas firep�ace <br /> Dish:washer � Gas range <br /> Clothes washer Clothes dryar <br /> Launtlry tray RangC hood <br /> _ Sirik(servicelbarlmop/eta) [xh-���st fan <br /> Dack9ow prever,l�r � Heal pump <br /> Urinal Und healer <br /> Onnking Pounlam � Boiler <br /> � Floor drain Refrigetation <br /> Grease trap Woodstave <br /> Rw�drains Other <br /> Olher <br /> CIiY OF EVEftE'iT LOCAL SALES TAX COOE IS J705 <br /> I hernby cer�bfy lnat I have read and ezamined this appi�calion and hnow the same to be true and correci. All provisions of laws and <br /> ordineces 9oveming th�s rype of work w�ll be comUlietl with vfiether spec�fed her¢in or not.The granhng ot a pe Tit does not presume <br /> to gwe authonty to violate or cancel the prowsion of any otner state or local law regulaling wnstruc6on or the peYormance o1 <br /> I construction.Thal I am authorizr.d by the ow�ner of this property to perform tlie work for which application is made and I mmpiy with t�e <br /> State Conlr 6 rs Law 1 P� RCW and 29G20D WAC. <br /> � �� '�( ��_ I � . <br /> Sigoaturo ol—�Ow�ne C,on raaor/Authonzetl Agent Date <br />