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SITE ADDRE55 <br />41G 74TH ST SW <br />L[GAL LOTNO. <br />D[SC � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — wwvd.everettwa.oig <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />DAVID 8 CHRISTINE LARSON <br />TENANTNAME <br />CONTRACTOR �A/ESCO <br />vv <br />CONTR. LICENSE N� AIAS H I ES�7 I OB <br />VV <br />USE OF 6UILDING <br />Residential <br />WORK DESCRIPTION <br />PARCEL TAX LD. # <br />00708000008600 _ <br />TRAGT <br />416 74TH ST SW <br />CONTACT FJR PERMIT <br />Jennifer Burqess <br />ADDRESS <br />3909 196 St SW, <br />HEATSOURCE <br />_Eiectnc �Gas_Olher <br />.. � I � / <br />PERMIT # <br />Evereu 9Bz03 425-41 H-5234 <br />PMONE <br />206-774-9499 <br />(y7y/Z�p PHONE <br />Lynnwootl 4r,us�; g00-398-4663 <br />ELECTRIC TO GAS 60K FURNAGE INSTALL WITH 50' GAS PIPING <br />NO. <br />G <br />TVPE OF FIXTURE OR ITEM <br />[3athtuU <br />Lavatory (wash basin) <br />Showcr <br />Kdchen sinh S disposal <br />Dishwasher <br />Clothes vrasher <br />Laundry tray <br />Sink (service/baUmop/etc ) <br />Backflow preventer <br />Urinal <br />Drinhing Fountain <br />Floor Aram <br />Greasetrap <br />Roof tlwins <br />OIM1ef <br />NO. <br />CONTRACT PRICE OF WORK <br />$40G6.60 <br />TVPE OF FIXTURE OR ITEM <br />A�C — m� hai�tlbno w�ds <br />ForceA an systems <br />Gas piping <br />Waten c�atcr <br />Gas hreplace <br />Gas range <br />Clothes myer <br />Range hood <br />E+�haust fan <br />Heat pump <br />Unn heatrr <br />eoiier <br />Refngerahon <br />Woodstove <br />Othef <br />CITV OF EVERETT LOCAL SALES TAR CODE IS 3105 <br />i hereby cent�fy that I have reatl antl eRamined Ihis apphcation antl hnowthe same to be true and correct. All prwisions of laws and <br />or�li�aces govetning ihis type o} work will be complietl wrth whether specdietl herein or not 1 ne grandng of a permit tloes not presume <br />tu 9v; ,° ;wthont� tn v�r,iat� nr c,incel the provision of any other state or local law regulahng construtlion or the pedormance of <br />con;tnid���n 1 c:�t I am auuiorced by Ihe owner of this property to perform the �wrti lor whtin applicanon is matle and I compry with the <br />_�tate Conuacl�r; t av: 1r1.: 7 RCW nnA 29f�:00 WAC <br />1 � I� II. u{re�J., e.ri+InMny.N <br />Jennifer Buraess 1110.'llmu,llrivin.1nn1`I++m�IM1'.I,Iq1H'A'll.ul/MIII:d11 <br />