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PERMIT I�PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — vwrN.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y ��(,�/Z <br />SITE ADDRESS PARCEL TAX I.D. # PER�d1T # <br />12529 22ND AVE SE ooe�7a0000�s�o �i)C � <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />OWNER A�DRE55 CINIZIP PHONE <br />JENNIFER ALBINO 12529 22ND AVE SE everett se2os 206-979-0827 <br />TENANTNAME <br />CONTRACTOR \A/ESCO <br />�� <br />CONTR. LICENSE # WA.S H I ESg% � OB <br />USE OF BUILDING <br />Commercial <br />WORK DESCRIPTION <br />Replace 50 gal gas water heater <br />NO. � YYPE OF FIXTURE OR ITEM <br />Toile[ <br />Bathtub <br />Lavatory (wash basin) <br />Sho,ver <br />Kitchen sink E Aisposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/oadmop/etc.) <br />Bachflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease [rap <br />Roof drains <br />Other <br />CONTACT FOR PERMIT <br />Jennifer Burgess <br />ADDRESS <br />39Q9 196 St SW, <br />HEATSOURCE <br />Electric � Gas _ Other <br />PHOIJE <br />206-774-9499 <br />qN21P PHONE <br />�ynnwoo� seoss $00-398-4663 <br />CONTRACT PRICE OF WORK <br />�D � %0� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas pip.�g <br />Water hear, � <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boller <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereUy ceritify that I have read and examined this application and hnow the same to be true and correci. All prwisions of laws and <br />ordinaces governing this rype of work v�nil be complied with whether specified herein or not The granling of a permit does not presume <br />to give authority to violate nr cancel the provision of any other state or local law regulating construction or [he peAormance of <br />construction. That I am authon_ed by the owner of this property to perform [he work for v+hich application is made and I compty wrth Ihe <br />State Contractors Law �827 RCW and 296200 WAC. <br />i c;i�.n� ,cr,m o-Nu,ru�. emqn, <br />J e n n, fe r B u rg e ss �,,:;�,,.��:m:,�a,,,��,t.,,_„�„�::�=„�HN�,.,,�_,�,,,,..tis, <br />I In'��Iingnv.M1�nmL<Sm t-115 <br />