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� 3`�l�I <br /> /U wt.rl�7 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, 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 PARCEL TAX I.D.N - PERMIT 0 <br /> 4905 Colb Ave 00377500000200 I (�l1oG� I I - R <br /> LEGA LOTNO. B�OCK TRACT <br /> DESC. <br /> OWNER ADORESS CITYZP PMONE I <br /> Emest Berg 4905 Colby Ave Everett 98208 425-23?_-9554 � <br /> TENANTNAME I CONTACTFORPERM17 PHONE <br /> Meiissa CrodalNorthwost Pormit Inc 360-945-2787 <br /> CONTRACTOR WESCO ADDRESS CITY2IP PNONE <br /> CONTRUCENSER WASHIES971 OB 2800 Thomdyke Ave W sean�e, se�ss 206-378-6649 <br /> USE OF BUILDINO I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> _E�eadc X Gas_otner $4,250.�0 <br /> WORK DESCRIPTION <br /> Replace a gas to gas 50 gallon water heater <br /> PI.UMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> _ Toiiet A/C-airhandlingunits <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> _ Shower 1 Waler heater <br /> _ Kitchen sink 8 dispasal Gas fireptace <br /> _ Dishwasher Gas 2nge <br /> _ Clothes washer Clolhes dryer <br /> � Laund tra — 9 <br /> — �' Y Ran e hood <br /> _ Sink(service/bar/mop/ett.) Exhausl fan <br /> _ Backflow prevenler Heat pump <br /> _ Unnal Unitheater <br /> Dnnking Fountain Boiler <br /> _ Floordrain Re(rigeretion <br /> _ Grease Irep Wootlstove <br /> _ Raof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3f06 <br /> I hereby cenlify ihat I have read and examined this application and know the same to be ime and corred. All provisions of laws and <br /> ordinaces goveming this type af work will be complied with whether speafied herein or not.The granting of a permit does nat presume <br /> to give authority to violate or cancel lhe provision ol any other stale or local law regulating consWction orthe periortnance of <br /> construclion.That I am authorized by tha owner oi this property to perfortn the work for which appliwtion is made and I cromply with the <br /> State Contradors Law 1827 RCW and 296.200 WAC. <br /> I 11/03/06 <br /> ignature o wner/ ontractor/Authorized gent ate <br /> L— <br />