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N3-2�-' l�8 12:99 CROM- T-865 P002/�02 F-929 <br /> � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 42b•257-8857—www.everettwa.org <br /> APPI.ICATIONs ARE ACCEPTED FROM e AM TO 4 PM <br /> SITE ADDRESS CARCEL TAX I.D.M PERMIT M <br /> 1613 6AKER AVE 00436933100700 �py�-(jl�� <br /> � LEOAI LOTNO. DLOCK TRACT <br /> OESC. <br /> yy AOD 6S CITYRIV P ON[ <br /> GERALD DALLMAN 1613 BAKER AVE, Everett 98201 425-258-418£ <br /> TENANTNAME I CONTACTFOHVERMIY PMONE <br /> Neida Khan/Northwest Permit Inc 360-945-2787 <br /> CONTR�CTOR \AIESCO �OREB$ CITV2IP VHONC <br /> IIV <br /> coNrn.uceNeet WASHIES971 OB z800 Thorndyke Ave W Seettle, 98189 800-398-4463 <br /> U58 OF BUILDING HEAT 80URCE CONTRACT PRICE OF WORK <br /> Residential I _Eledric x_GasTOther $�50.�� <br /> WORK DESCRIPTION <br /> Replacing a gas to gas 40 gallon water heater <br /> PLUMBING MECHANICAL <br /> NO. riP8 OF FIXTURE OR ITHM N0. riP[OF FU(TURE OR ITEM <br /> Toilet NC—air handling unils <br /> � Dathlub ^ Forced eir systems <br /> Lavalory(wesh baNn) Oas piping <br /> Shower + Water heater <br /> Wtchen eink 8 disposal Gas Broplace <br /> Oishwasher Oas renpe <br /> � Clolhes washer Ciothas dryer <br /> Lnundry lray Ranpe hood <br /> � Sink(servicelbar/mopletc.) _ Exhauit fen <br /> Bedcflow pravenler Heal pump <br /> Urinal � Unit heeler <br /> Drinking Founlein Boiler <br /> ! Floor drein � Refrigeration <br /> Grease lrap Waadelove <br /> � Raof dreins � Other <br /> Olhet <br /> CI7Y OF EVER@TT LOCAL SALES�A%CODE IS�106 <br /> i hereby cen6ly that I have read nnd examined this applieeuon and know lhe same ro he true and corred. All provislons ol laws antl <br /> ordinaces governing lhis rype of work will 6e complied vnth whelher specdied herein or not The 9ranting ol a pertnll does not prosume <br /> to grve authoriry to vioiate ar cancel the provisian af any other slato or local law regulatinfl consVuction or the pertormance o( <br /> consttuclion.Thal I am au�horized by the owner of this pioperty fo pertorm ihe vvork for which applicaUon is mede and I comply wilh Ihe <br /> Smle Convacl rs�aw 1827 RCW and 296200 WAC. <br /> � ZD (�� <br /> SignaWre o Owner/C ntr ctor 1u iorizod Agan a e <br />