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SITE ADDRESS <br />502 74TH ST SW <br />LfGAL LOT NO. <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 - www,everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCH <br />ROBERT 8 RASHIDA HARRIS <br />TENPNTNAME <br />CONTRACTOR �A/ESCO <br />CONTR. LICENSE H WASH I ES971 OB <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />REPI.ACF GAS SOK BTU FURPJACE <br />PLUMB <br />NO. I TVPEOFFIXTUREORITEM <br />To!let <br />�alhtub <br />Lavatory (w�sh basin) <br />Shower <br />Kttchen slnh & tlisposal <br />Dishwasher <br />Clothes washer <br />LaunUry tray <br />SmA (service/barlmopletc ) <br />8ackflow preventer <br />Urmol <br />Dnnhin� Fountain <br />Floor Arain <br />�reasetrap <br />Roor arams <br />Other <br />PARCELTAKI.D.# <br />00�08000009ioo <br />rRncr <br />PERMIT k <br />� � � L��: <br />SAME AS SITE ADDRESSS Everet198201 425-290-8349 <br />CONTACT FOR PERMIT <br />Naida Khan <br />ADDRESS <br />2800 Thorndyke <br />HEATSOURCE <br />_ Electnc � Gas _ Other <br />PHONE <br />360-945-2787 <br />qTV21P PHONE <br />SEATTLE 800-398-4663 <br />CONTRACT PRICE OF WORK <br />2401.00 <br />NO. I TVPE OF FIXTUREOR ITEM <br />A/G — �If hafltlling unlis <br />Potcetl air systems <br />Gas pipin� <br />Water heatcr <br />Gas ftreplace <br />Gas ran�e <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />UnR heater <br />Boder <br />Refrigeration <br />Wootlstove <br />�ITV OF EVERETT LOCAL SALES TFUf CODE IS 3105 <br />i hereUy centity lhat I have read and examined ihls apphcahon and hnow ihe same to be true and correct All provislcns of laws antl <br />nramaces govermng this type of wvrh will Ue mmphed vnth whether specRietl here�n or not The grentmg of a permt does not presume <br />h.� grve aidhonty to violate or cancel ihe prowsion of any other state a local law regulating mcstruction or the pr.Aor nance of <br />crnistruc7ion That I am authorized by the owner of this property to per}orm the �+»rk for wh�cl•, apphcation is made a�tl I mmply wRh the <br />:;tale Contractors Law 18 27 RCW and 296 200 WAC <br />- 5/31 / 11 <br />Signature o Owner! oniroctor/ uthorized gent ate <br />