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— - � -- - , �_ . .. .._ .. . .. .� ,.. <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D CEDi+R STREET, EVEP.ETT. Wi� 98201 <br /> �25-257-8810 - F/�X 425-257-9857 -wwv✓everettwa.org <br /> I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ' $ITE AODRESS PARCEL TAX I.D.t! PERMIT M <br /> 1408 COLf3Y AVE 00438529302900 - � <br /> LEGA� LOT N0. BLOCN iRACT <br /> DESC <br /> , OWNER ADDRE55 CITYlLP VHONE <br /> � GERALD & GWENDOLYN KEILMAN 1408 COLBY AVE Evere�t 9820� 425-259-4689 <br /> 7ENANT NAME CONTACT FOR PERtA1T PMONE <br /> JENNIFER COVELLO 206-774-9499 <br /> CONTRACTOR �/l/ESCO ADDRESS GTY/IIP PHONE <br /> �� 3909 196th St SW Lynnwood 800-398-4663 <br /> COHTR.UCENSE 1�WASHI�S97�OB <br /> � USE OF BUILDING - - HEAT SOURCE I CONTRACT pRICE OF WORK <br /> RESIDENTIAL _e;eci��� y Gas_Other 4142 <br /> WORK DESCRIPt10N <br /> GAS TO GAS TANKLESS WATER HEATER WITH 10' GAS PIPING <br /> PLUMBiNG MECHANICAL I <br /> NO. I TVPE OF FIXTURE OR I7EM N0. TYPE OF fl%TURE OR ITEM <br /> I _ TOde� !VC-di(h3�dlill� U0115 I <br /> ' _ BalhWb ^' Forcetl a�r;ystems <br /> _ Lavatory(wash basin� + Gas p�p�n3 <br /> Shawer i Wat?r heater <br /> I _ Kdchen smk 8 disposal _ Gas'�replace <br /> D�shwasher Gas ranoe <br /> ' _ Clothes wa5her Clothes dryer <br /> __ Laundry tray Range hood <br /> __ Sink (service/bar/mop�etc � Exhaust tan <br /> _ �acktlow preventer Heat pump <br /> __ Unnal Unit heater ' <br /> _ DnnMingFountain _ Boiler I <br /> i � FIoOr Orain _ Refngera6on i <br /> Grease trap Wood,tove <br /> Rool drains Other <br /> Oiher — --"- <br /> ' qTY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> iI 1,ereby cerilify lhat 1 have reed and examinetl th�s appGcat�on znd know the same to b?tiue antl correct Ail provis�ons o(laws and <br /> ordmaces goveming ih�s type o1 work win be wmplied wrth whe[her spec�f�ed herem or not The granbng ol a pe:md does not presumc <br /> io gr:e aufhordy 10 vwiate or cancel the prov�sion of any other slate or local law regulatmg consl�uG�on or the perlormance of <br /> ccr;�rucbon That I am auth�riz=d by the owner o(this property to peAorm the work for which apphcanon is made and I comply wdh ll�? <br /> �tair- Cuntradors Law 18 ?% RCW and 29¢,ZQ(��/1��,�„n,�cr�•n <br /> Jennifer Covello °°°��...�..�..��_�~�,��.���° � <br /> I - _ .._,.,..,,._...�;�x.�m,.�. <br /> ..,..�,.�,�4 . <br /> �ynaturu ct UJmonConfra_io:�Authonzed Agent ale <br /> � ---- .. . - ------------------ - - - ---- - - -__. I <br />