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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�25-257-8810 - FAX 425-257-8857 - wwva.everettwa.org <br />SITE ADDRESS <br />2223 TAYLOR DR <br />IEG�•l LOT NO. <br />D[SC <br />ROBERTJACOBSON <br />TENANTNAME <br />CONTPACTOR �/1/ESCO <br />VV <br />APPLICATIONS ARF ACCEPTED FROM 8 AM TO 4 PM <br />BIOCK <br />CONTR. LICENSE a WASH IES9 i 1 OB <br />USE OF BUILDING <br />RESIDENTIAL <br />WORK DESCRIPTION <br />REPLACE GAS Wl1TER HEATER <br />PLUMBING <br />NO. I TVPE OF FIXTURE OR ITEM <br />Todet <br />8athtub <br />Lavatory (wash basin) <br />Shower <br />Kitdien sink S disposal <br />D�shwasher <br />CIOU�es v.�asher <br />Laundry iray <br />Smk (sernce/barlmop�etc ) <br />[3achflow preventer <br />Urinal <br />Dnnk.mg Fountain <br />Fioor diain <br />Greasc trap <br />Rool drains <br />Olhcr <br />PARCEL TAX I.D. fF <br />o0a170o0101002 <br />TRACT <br />�is� a�J --i�! <br />PERMIT M <br />nn�Uhi.l_F <br />CITv/2iP PHONE <br />2223 TAYLOR DR Everclt 98208 425-422-7798 <br />CONTAGT FOR PERMIT PMONE <br />JENNIFER COVELLO 206-774-9499 <br />A�DRESS CITY/ZIP PHONE <br />3909 196th St SW Lynnwood 800-398-4663 <br />NEATSOURCE <br />_ Ei?C;nC � Gas _ Other <br />NO. <br />� <br />CONTRACT PRICE OF WORK <br />a � �� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEIA <br />A/G - air hantlhng units <br />Forcetl av syslems <br />Gas piP�ng <br />Water heater <br />Gas firepiace <br />Gasiange <br />Clothes drycr <br />Range hood <br />E+hau5ilan <br />Heatpump <br />Unrt heater <br />Dalei <br />Relrigerat�on <br />Woodslove <br />Other_ <br />CITY OF EVERETT I.00AL SALES TAX CODE IS 3105 <br />I hereby cenhty that I have reaa and eaammed this applicaLon ar�d know the same to be true and wnect All provisions ol law, and <br />orAinaCes goveming this rype ol work Hvll be cCnplied with whether spealied herein or not The grant�ng of a permd does not Oresume <br />to give authorAy to violate or cancel �he provision ol any ether state or local la�v regulabng wnstruct�on or me perfarmance of <br />construcUon That I am autnorized by the owner ol this property to pertorm U�e work for which apphcaLon is matle antl I comply with the <br />Stale Contractors �aw 18 27 RCW and 29 p W /� <br />�,�c.�✓�n�aEf„�-�• �co.r�a <br />Jennifer Covello °'��°���"�°.�° ,�p.°�°°�.m°�.�°° <br />,:�.�;:,1._A..°.,m «�, <br />�-ro <br />Signature o1 OwnedConUactor/Authorizetl Aoenf � Oate <br />