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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRECT, CVCRCTT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www,everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. 0 <br />PERMIT # <br />4721 BELEVEDERE AVE <br />00417100003502 <br />;. <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DCGC. <br />OWNER ADDR989 CITYrZIP PHONE_ <br />ROGER HOOT 4721 BELEVEDERE AVE, Evcrctt 98203 425-220-8981 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Nelda Khan/Northwest Permit Inc 360-946-2787 <br />CONTRACTOR WESCO ADDRESS CITYIZIP PHONE <br />2800 Thorndyke Ave W Seattle, 98199 800-398-4463 <br />CONTR. LICENSE# WASHIES971 OB <br />USE of BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Residential <br />_Electric X Gas —Other <br />$18,011.00 <br />WORK DESCRIPTION <br />Installing 1 Bryant 100K btu gas furnace, 1 Bryant 3.5 ton (42K btu) heat pump, 1 electric <br />to gas tankless water heater, and gas piping for the furnace and water heater (2 outlets). <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />A76 —air handling units <br />Toilet <br />Bathtub <br />em <br />Forced airsystems <br />— _ <br />Lavatory (wash basml <br />z <br />rat niNnn <br />Snower <br />1 <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />i <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />_ <br />Sink (servicelbarrmop/etc.) <br />Exhaust fan <br />Dackflow preventer <br />Heal pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />_ <br />_ <br />Floor drain <br />ReMgcmtion <br />_ <br />Grease trap <br />Woodsove <br />_ <br />Roof drains <br />Other <br />Olhar <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />I hereby cedlify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinecoa goveming this type of work will be eomp,ied with whether epecined herein or "at The granting or,, pennil does not presume <br />to give authority to violate or atncel the provision of any other state or local law regulating constructlon or the performance of <br />construction. That I am authorized by the owner of lnis property to dorm the wodfor which application Is made and I comply with the <br />Slate Contra rn Law 10, CW and 208.200 WAC. <br />Signature of CmerIC07or/ Ulhnnzed Agent <br />J <br />