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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425257-8857—www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESr PARCEL TAX I.D.# PERMIT# <br /> 8501 6TH AVE SE a0F�000000oto0 (Yl �0 `� �`F�- <br /> LEGA' LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS pN21P PHONE <br /> RON L HANSON same as site address 98208 425-353-2482 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> ICyndal/Naida 360-945-2787 <br /> CONTRACTOR \A/ESCO ADDRE55 dTY/ZIP PHONE <br /> �� 2�00 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENSE#�A/ASHIES9/ � OB <br /> VV <br /> USE O� BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> residential I _Electric ��as_Other 950.00 <br /> WORK DF;CRIPTION <br /> REPLACE GAS 50 GALLON HO i WATER HEATER <br /> PLUMBING �— MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ r+/C—air handling units . <br /> Bathtub _ Forced air systems <br /> Lavatory (wash basin) _ Gas piping <br /> Shower i Water heater <br /> Kitchen sink E disposal _ Gas fueplace <br /> Dishwasher _ Gas range <br /> Clotheswasher _ Clothesdryer <br /> Laundry tray _ Range hood <br /> Sink (service/bar/mop/etc.) _ Exhaustfan <br /> Bachflowpreventer _ Heatpump <br /> Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> Floor drain Refrigzration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CIiY OF �VERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritity Ihat I have read and examinetl this applica[ion and hnow the same to be true and correct All prwisions of laws and <br /> ordinaces goveming ihistype of v�rorh will be complied Hnth whether specified herein or not.The granting of a permi[tloes not presume � <br /> to give authority to violate or cancel the provision of any other state or local law regulating wnstruction or the pertormance of � <br /> construction. That I am authorized by the o�mer of this property to pertorm the work for which application is made and I rnmpty with the <br /> State Con[ractors Law 1827 RCW and 296200 WAC. <br /> - - 2/24/12 <br /> Signature of Owner/ContractoUAuthori_ed Agent Date <br />