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— -� <br /> PERMtT AF�PLICATION <br /> CITY OF EVERETI� PERMIT SERVICES <br /> 3200 CEDAR STREE.T, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-?57-8857-www.everethva.org <br /> APPLICATIONS ARE ACI�EPTED FROM 8 AM TO 4 PM q -a4-�Z <br /> SITE ADDRESS PARCEL 1�AX I.D. N PERMI'. # <br /> 1404 Ballew Ave 0039A 100300100 �,(� - Uy� <br /> LEGAL LOT NO. BLOCH TRACT <br /> DESC <br /> OWNER AGDRESS QTV/ZIP PHONE <br /> James Maclachlan 1404 Ballew Ave EvereU 98203 425-231-6117 <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> Jennifer Burgess 206-774-9499 <br /> CONTRACTOR \A/ESCO ADDRESS QTV/ZIP PHONE <br /> VV 3909 196 St SW� Lynnwood 98036 800-398-4663 <br /> CONTR.IICENSE N wASHIES971 OB <br /> USE OF BUILDING fiEAT SOURCE CONTRACT PRICE OF WORK <br /> C.OfT1f118fC1a� _Electnc �Gas_Other $9102.20 <br /> WORK DESCRIPTION <br /> Electric to gas 60K furnace with 35 ft new gas piping and Elec to gas tankless water heater <br /> with 5 it of new gas piping <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-au handling units <br /> Bathtub � Forced air systems <br /> Lavatory (wash basin� ? Gas piping <br /> Shower i Water heater <br /> hRchen sink E tlisposal Gas fueplace <br /> Dishwasher Gas ra� ge <br /> CblheS washei Cb�hes dryer <br /> Laundry tray _ R�nye hood <br /> Smk (service/baUmop/etc ) E+haustfan <br /> Backflow preventer Heat pump <br /> Unnal Un2 heater <br /> [Jnnking Fountain Boiler <br /> Floor dram Refngeial�on <br /> Grease trap Woodstwe <br /> Hoof Arams Oth2f ,___ <br /> -- O�hP.f <br /> CITV OF EVERETT LOCAL SaLES TAl(CODE IS]705 <br /> i heieUy centity that I have read antl e�aminetl th�s apphcadon an tl know the same to be Vue and correcl All provisions oi laws and <br /> orh�naces governmg this type of woik will be complied wnth whether specrtietl herein or not The grantmg of a permrt Aoes not presume <br /> tn prvP aidhonty to violatP or cancel the prowsion of any other stata or local law regulahng construdion or ihe pertormance o? <br /> consPucLon That I am a�dhon�etl by Ihe owner ot this property�o perform Ihe w0�h foi wh�ch applicalion is made antl I cor�ply with Uie <br /> Staic Contractors Law 1r'� :7 RCW and 796 200 WAC <br /> I i il'Yl14��i.•••1�.:r,i�ll.�X�I��r.�� <br /> Jennifer Bur�ess Ib n �tnrinNu��-u 11MIlAV`IIIFMII nlINI11K� I <br /> IIIA'I� �m.nl P�������+:rul.nmi��.:T� li5 <br /> Si9n.iture of�Owner/Contracro Au[horrad � e� � - "�� � ate <br />