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OG-25-'00 13:95 FROf1- T-67Z F002/003 F-153 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-�07-8857-www everettwa.org <br /> APPLICATIONS AfiE ACCEPTED FROM 8 AM TO 4 PM b � -D�.� <br /> SITE ADDR[SS PARCEL TAX I.D.N PERMIT M <br /> 1402 COLBY AVE 00438529303100 ��� ����!l, D<�� <br /> L[GAL LOT NO. BLOCK TMCT <br /> UESC. <br /> OWN[R ADDHE85 CITYIZIV PHONE <br /> STAN GELLERSON 1402 COLBY AVE, Everett 98201 425-252-6139 <br /> TENANT NAME I CONTACT FOR PER�d1T PNONfl — I <br /> Naida Khan/Northwest Permil Inc 360-945-27t37 <br /> CONTRACTOR W�SCO ADORESS CITY2IP PHONE <br /> CONTR.LICLNS[► WASHIES971 OB z800l�horndyke Ave W sean�e,se�ss 206-378-6649 <br /> USE OF�UIL�ING HEAT SOURCE CONTR.4CT PRICE OF WORK <br /> Residential I ^Electric x Gas,Other I �950.00 <br /> ! WORK�ESCR�PTION <br /> Replacing 1 gas to gas 50 gallon waier heater <br /> — PLUMBING MECHANICAL <br /> NO. 7YPE OF PIXTURE OR ITCM N0. tYPH OF FIXTURE OR tiEM <br /> Toilel AIC—atr handling unils <br /> Dalhtub � Forced air systems <br /> � ! Lavatory(wash basin) Gas pipin0 <br /> Shower ' Waler heater <br /> � Kitchen sink&disposal Gas Lreplace <br /> Dishwasher � Gas range <br /> C�othes washer Clothes dryer <br /> Laundry tray _ Range hoocl <br /> Sink{servlcolbar/mo�etc.) Ezhausl lan <br /> 62ckllow preventer _ Neat pump <br /> � � Urinel Unit heater <br /> DrinKing FouMain _ 6oller <br /> Floor drain Rofrigeralion <br /> Grease trap _ Woodslove <br /> Roof drains Other <br /> Othe� <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3705 <br /> I hereby centiy that I have read and examined tnis ap0����ion and know the same�o be lrue and corred. A�i provisions ol laws and <br /> ordmacea governing fhis type o�Work Nn��be complied vnlh whelher speUfied herein or not The grantlng of a permit dces nol presume <br /> to g�ve aulhority to woiate or cancel the provision of any other sWte or ioca�law regulating construdion or Ihe peAormance ol <br /> conslruc6on. That I am authorized hy the o•.vrrer of Ihis property lo pertorm the work for wlvch application is mada and i comp�y vnth the <br /> State Co �i2c ors Law 1827 CW and 2P5 WAC. <br /> �� �' `� <br /> SiOnatu �of erfCoNraclo iAu honzetl Agent Date <br />