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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425.257-8857 — www.everettwa,ot g <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. M <br />PERMIT # <br />"61) <br />203 73RD ST SW <br />00731000003400 <br />(�JG <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC <br />OWNER ADDRESS aTV2IP PHONE <br />RUSSELL & TERRY PALMER 203 73RD ST SW Everett98203 425-501-9538_ <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Jennifer Burgess 206-774-9499 <br />CONTRACTOR WESCO ADDRESS PHONE800-398-4663 <br />3909 196 St SW, Lynnwood 98036 <br />CONTR. LICENSE# WASHIES•97 .I I OB <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Residential <br />— Electric 10—Gas_ Other <br />I 4500.00 <br />— <br />WORK DESCRIPTION <br />Install gas fireplace with 10' gas piping <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />I <br />Gas piping <br />Shower <br />_ <br />Water heater <br />Kitchen sink & disposal <br />I_ <br />Gas fireplace <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Laundry tray <br />_ <br />Range hood <br />_ <br />Sink (service/bar/mop/etc) <br />__ <br />Exhaust tan <br />_ <br />Backflow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boner <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstwe <br />_ <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerdify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing thistype of work w it be complied with whether specified herein or not The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction That I am authorized by the owner of this property to perform the work for which application Is made and I comply with the <br />State Contractors Law 18 27 RCW and 296i 200 <br />0 WAC.x^sx <br />n1llmxmJntuy nu•NOx11ANSi flFMl. uu•N NIIM 51 <br />Jennifer Bur ee5S Vlplll, em.x.lmnxn/rrwyn.nnium x•US <br />Signs ore o ner contracto ut or •ed eta <br />