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SITE ADDRESS <br />1720 124TI1 PL S[ <br />LEGAL LOT NO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8870 — FAX 425-257-8857 — www.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROIA 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. �I <br />�` : <br />CC•.1)ARHII.L INVIiSTA11�NT5 I.LC 83J2 RTf� ST SE liVliRt:T'f �8205 1425) 422-0877 _ <br />TENANTNAME I CONTACTFORPERMIT PNONE <br />KLN RODINSON-L'LMSLIf (_3yS� »ni-74G2 <br />CONTRACTOR ADDRESS CITVlZIP PHONE <br />ROf31NSON PLl I11flING INC. 293;0 1247�11 A1'li N I�. ARLINGTOti 9R223 � seo�aoi.�aaz <br />CONTR. LICENSE 1 RO-BI-NP-�272('2 <br />USE OF BUILDING <br />SINGI.G PAMII.Y RI�.SIDI?NCIi <br />WORK DESCRIF�?i9N <br />HEAT SOURCE <br />_ Eledric __ Gas _ Other <br />INSTAI.L IlRli SPRINKI.CR Sti'S'I'IT1 IN NL'N' SFR <br />NO. � TVPE OF FI%TURE OR ITEM <br />� <br />� <br />� <br />Bethtub <br />Levatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry trey <br />Smk (service/bar/moplelc ) <br />Backflow prevenler <br />Unnal <br />Dnnking Founlain <br />Floor drain <br />Greasetrap <br />Rouf draina <br />Other _ <br />CONTRACT PRICE OF WORK <br />$J100 <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />For�:3d air systems <br />Gas piping <br />Waler haeter <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Renge hood <br />Eahaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refnperation <br />Woodstove <br />Other <br />.�r �u W.dLls <br />CITY OF EVEHETT LOCAL SALES TA% CODE IS J105 <br />I hereby centify that I have read and e�amined Ihis eppfica6on and know the same to be true and conect. All provisiuns ol laws end <br />ordmaces goveming this type of work will be comphed v�+lh wfiether apecfied herein or nol The granling of e pertnit does not presume <br />lo grve au0ionry to violate or cancel Ihe provision ol eny other slale or toca� law repulating construction or the peAormance ot <br />constructlon Thal I am authorized by the owner of Ihis properry to paAortn the work for whlch appllcaUon ia made end I comply vath Ihe <br />Slate Contractors La 18 27 RCN( and 296 200 WAC <br />t-�!l l ��-_ _/ i. �/ �//nC <br />