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( <br /> P'ERMIT APP.LICATION <br /> CITY O�F ED RS�REE7 e�RM� SERV�ICES yay5 <br /> • 425-257-8810—FAX 425-257-8857—www,everettwa.org �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# P MIT# <br /> 4532 Ever reen Wa ooso55o2200900 �C — C% <br /> LEGAL LOiNO. BLOCK TRACT <br /> �esc. LOT s BLK o22 D-oo VICTORY HEIGHTS ADD TO EVERETT <br /> OWNER ADDRESS CIN7ZIp PHONE <br /> Kanes Too Inc 4532 Evergreen Way Everett98203 425•252-6162 <br /> TENANTNAME CONiACiFCRPERMIT PHONE' <br /> IMelissa Croda 360-945-2787 <br /> CONTRACTOR 1A/ESCO AD�RESS CITYIZIP PHONE <br /> �� 2800 Thornd ke SEATTLE 206-378-6649 <br /> CONTR.LICENS E/!1��AS H I ES 971 O B � <br /> VV <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _eie�c��� 1�Gas Other I 950 00 <br /> WORK DESCRIPTION <br /> Replace gas to gas 50 gallon 40,000 btu water heator <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR I7EM <br /> _ Toilot _ A/C—airhandlingunits <br /> _ Bathtu6 Forced air systems <br /> _ Lavalory(wash basiq) — <br /> Shower _ Gas piping <br /> Kitchen sink G disposai ? Water heater <br /> Dishwashar _ Gas firaplaco <br /> —' Gesrange <br /> _ Clolhes washer Clothes drye. <br /> _ Laundry tray Ran�e hood <br /> _ Sink(servico/badmop/etc.) Exhaust fan <br /> _ BackOowpreventer Healpump <br /> _ Urinal Unit healer <br /> _ Drinking Fountain Boilor <br /> _ Floor drain Refrigeration <br /> _ Grease Irap Woodslovo <br /> _ Roo/drains Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3f 05 <br /> I hereby ceritify tha`I havo read and examined this applicapon and know iho same to be irue and correci. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whelher specified herein or not.Tho granting of a permit does not presume <br /> to give aufhoriry to violate or cancel the provision of any other state or local law regulaling conslruction or the peAormance of <br /> construction.That I am aulhorized by tho owner ot this property to pertorm the work for which application is made and I comply with the <br /> Stale CoNractors Law 18.27 RCW and 29G.200 WAC. <br /> SignatureotOwneCCont' r�p(pN��or�� a/��IQ <br />