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12-23-'10 13:17 FAOM-rnu nermit 13609952091 T•-839 P43621003 F-296 <br /> � ( , <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EYERETT,WA 98201 <br /> 425-267-8810—FAX 425-257-6857—www.everettwa.org <br /> APPLICATION3 ARE ACCEPTED FROM t AM TO 4 YM I�a-3��� <br /> SITE ADDRESS PARCEL TAX I.D.� PERMIT k <br /> 4604 COLBY AVE 00407801004900 'a - C�g <br /> LEGAL LOT NO. BLOCK TRACT <br /> OESC. <br /> OWNER ADDRESS CI 21P PN <br /> DONNA HAU::K 4604 COLBY AVE everett 98203 425-259-1573 <br /> TENANiNAME CONTACTRORPERMIT PMONE <br /> INaida Khan 360-945-2787 <br /> CONTRAGTOR \�/ESCO AODRESC CITYRIP � PHONE <br /> �� �7 2800 Thorndyke SEATTLE 800-398-4663 <br /> CONTR.LICENEE/WAS H I ES9! �O B <br /> USE OF BUILDIN6 HEAT SOURCE CONTRACT PRICE OF WORK I <br /> SFR I _aectn. �oes_o;her $3500.00 <br /> � WORK DESCRIPTION <br /> REPLACE 40 GAL GAS WATER HEATER <br /> PLUMBIN(i MHCHANICAL <br /> N0. TYPE OF FIRTURE OR I7EM NO. TVPE OF FIXTURE OR ITEM <br /> Toilet _ A/C-alr handlinp unha <br /> Belhlub Forced eir systems <br /> _ Lavatory(wesh besinJ _ Gu piping <br /> Shower � Weter heater <br /> `� Kitchen sink 3 dispOSal _ Gas Rroplece <br /> Dishwesher (iasranpe <br /> Clolhes washar _ Clathes dryer <br /> Laundry tray _ Ranpe hood <br /> S�nk(serviceltfa�lroop/et0.) _ Exheust fe� <br /> BeckAow pravanter _ Heal pump <br /> Urinal Unit heeter <br /> _ Dnnking Fountein _ Boilo� <br /> Floor drain Ref�iperetion <br /> Greaw trap _ Woodstwe <br /> Roof dralns Ofher <br /> O�her <br /> CITY OF EVBRETY LDCAL MLE�TAX CODE IS 7705 <br /> I hareby cerilify ihal I heva ned end meemined ihls application end know Ilx eeme to be lrue and corrad� All provisione of laws and <br /> or0lnoces governinp this lype ol work wili be camplied with wlrethe�e{wciBW herefn or not.The prentinp ol n p�rtMt don rrot preaumc <br /> to pive authorily to violate or cancel lhe provision o1 any olher etete or loeel lew repulatinq ConsWclion ar the perfo.nnena o1 <br /> conslruction.7het I em authorized by ths owner of fhis property lo parform the worfc for which applleetian is mada and I comp�y with lhe <br /> Slete Contraciors Law 18.27 RCW and 286.200 WAC. <br /> -� ��1��G4./�Q <br /> �gnamre of Uw�edConlrector t orae pen� a <br />