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04-19-'07 19:20 FROM- <br />� <br />PERMIT APPLICATIc7N <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 />T-059 PD02/002 F-107 <br />65�� <br />N <br />APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM �{ �- \�j �D % <br />SITE ADDRE53 PARCEL TAX I.D. H PERMIT # <br />731 Colby Ave 00497013800400 � �� � � <br />LEGAL LOTNO. R�OCK TMGi <br />DESC. <br />OWNER AO�RESS CI7Y7ZIP PHONE <br />Betsy Mueller 731 Colby Ave Everetl 98201 425-259-3029 <br />7ENANT NAME CONTACT FOR PERM�T PIIONE <br />Melissa Croda 360-945�2787 <br />CONTRACTOR 1I1/ESCO <br />vv <br />coNrR. uceHse,r WASHIES971 OB <br />�SE OF DUIL�ING <br />SFR <br />WORK DESCRIPTION <br />ADDRESS CITY2IP PHONE <br />2800 Thorndyke SEATTLE 206-378-6649 <br />HEATSOURCE <br />_Etectnc �Gas„Olher <br />Replace gas to gas 50 gallon 40,000 btu water heater <br />NO, � TYPEOFFIX7UREORITEM <br />Toiiet <br />ealhtub <br />Lavatory (wash hasin) <br />ShOwEf <br />Kitchen sink & disp�sal <br />� Dishwasher <br />Clothes washer <br />^ Laundry tray <br />Sink (servicJbedmop/ela) <br />Oockilow prevenler <br />Urinal <br />Drinking Founlein <br />� floordrnin <br />Grease Vap <br />� Roof drains <br />Other <br />CONTRACT PRIGE OF WORK <br />950.00 <br />N0� � TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Korced eir syslems <br />Gas plping <br />Waler heater <br />Gas freplace <br />Gas range <br />Clothes dryer <br />Rengehood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Retrigerolion <br />Woodstove <br />Other <br />CItY OF EVERET7 LOCAL SALES TAX CODE IS 7106 <br />I hereby ceritify lhat I have read and ezamined Ihls appliwlion and know the samc to he lrua and wrred. All ptovisions o( lav.5 and <br />ordinaces 9cverning lhis ryp�s ot work vnll be compfied vAth whether speei5ed herein or noL The granting ot a permit tloos not presume <br />lo give authority to vio�ate or cancei the provision of any other slate or local iaw regulating wnstruclion or lhe pedormance oi <br />conslruclion. That I am authorized by the owner of this property to perform the work for whiGi �pplication is mede and I comply with the <br />Siale Contradors Law 10.27 RCW �nd 296.200 WAC. <br />�.��� y/��/� <br />�;�- Signature o OwnerlContr etoNAuthonzed Age t Date <br />