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09-28-'10 09:32 FROM-nw permit 13609452091 T-975 PO1�2;903 F-793 <br /> � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-v✓ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM q _ ag— /� <br /> SITE ADDRESS PARC[L TAX I.D.M PERMIT M �, <br /> 1515 COLBY AVE 00553632100a00 Z �Uv�� - p�j <br /> LEGAL LOTNO. SLOCK TRACT <br /> DESC. <br /> OWNER AODRESS CITY/ZIP PNONE <br /> BENJAMINE ENGELHART samu as site address ever 98201 425-252-7075 <br /> 7EN,►NT NnxiE CONTACT FOR PERMIT vNONE <br /> INaida Khan/Cyndal Millhollin 360-945-2787 <br /> CONTRACTOR 1��ESCO ADDRE53 C�tt/ZIP PNONE <br /> CONTR.LICENSEp 2800 Thorndyke SEATTLE 800-398-4663 <br /> WASHIES971 OB <br /> USE OF 6UILDING I HEAT 30URCE CONTRACT PRICE OF WORK <br /> RESIDENTIAL _e�edric �Gas_Other I $4398.00 <br /> WORK DHSCRIPTION � <br /> REPLACE GAS 80K BTU FURNACE <br /> PLUM8ING MECHANICAL <br /> N0. TYPE OP FI%TURE OR ITEM NO- 7YVE OF FIXTUHE OR ITEM <br /> _ Toilel A/C—airhandlinguni(s <br /> _ Bathtub ± Forced air systems <br /> _ Lavalory(wash basin) Gas pip�ng <br /> _ Shower _ Water heater <br /> _ Kitchen cink B disposal _ Gas firepiace <br /> _ Dishwasher Gasranpa <br /> _ Cioihes washer Clothes dryer <br /> _ Laundry lray Range hood <br /> _ Sink(service/bar/mop/etc.) Exhaust fan <br /> _ BadcAnw preventer Heat pump <br /> Urinal Unit heate� <br /> _ Drinking Founlain Ooiler <br /> _ Ploor drain Refrigeration <br /> Grease Vap WooGstove <br /> Roof dreins CNhgr <br /> Othet <br /> CI7V OF GVERETT LOCAL SALES TAJ(CO�E IB J10b <br /> I hereby cer�t�fy thal l have read an�examined Ihis applicalion and know the same to be true and correcl. hll provisionS of laws and <br /> ordinaces goveming th�s rype of vrork vnll be complietl with whelher specified hereln or not.The granting of a permit does not presume � <br /> 10 give authoriry to vioiate or cancel the provision of any other stale or local law regulating conslruction or ihe peAormance ol <br /> wns�ruGiort That I am authorized by the owner of this property to perlorm lhe worV,!or vmich applicalion is made end I comply with Uie <br /> Stele Conlr ctors Law 1827 RCW and 298.200 WAC. <br /> ---- z� �alo <br /> igna ur ner! ntracto Ad i " enl ate <br /> I <br />