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1���_l;fc, -c���OC Nwwh <br /> NERMIT APPLICATION <br /> C17Y OF EVERETT F'ERMIT SERVICES <br /> 3200 CEDAR STREET, E�VERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-0857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1 '� `O� <br /> SfTE AUDRESS PARCEL TAX I.D.q PERMIT p <br /> 2611 1/2 Calb Ave I 005624siz0osoo I ��;'�,/'�. ><,� <br /> LEGAI LOTNO. BLOCK TRACT ' <br /> DESC. 6 612 I Ruckers 1 st Plat <br /> OWNGR AUPRG33 CT'ZP PNOqE <br /> Mark Werts 2611 1/2 Colby Ave Everett 98201 425-339-8414 <br /> lEN/1NT IiAME CONTACT FOR PERMIT PHONE <br /> IMelissa Croda 360-945-2787 <br /> CONTRACTOR 1Il/ESCO �DRESS CIiY(ZIP PHON[ <br /> YV 2800 Thorndyke SEATTLE 206-378-6649 <br /> wrrrn.uceNser WASHIES971 OB <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR I _Elecuic 1�Gas_Other 750.00 <br /> WORK DESCRIVTION <br /> Replace gas to g�s 40 gallon water heater <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR t7EM NO. 7YDE OF FIXTURE OR REM <br /> Toilet NC -oin c�ndling unita <br /> 6alhtub Forced air systems <br /> Lavatary(wash�asin) Gas pipi�g <br /> ShOWCf � W�tarha�i,f <br /> —' Kltchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer f..l�tnos dryer <br /> Laundry ttay _ Ranga hoocl <br /> Sink(seroicefoadmop/elc.) 6chaust(an <br /> Backltow prevenler _ Heat pump <br /> Urinai Unit heater <br /> Grinking Fountaln _ 6oiler <br /> Floor drain Retriperation <br /> —` Grease trap Woodstove <br /> Roof dralns Oth¢r <br /> Olher <br /> GT'oF EVERETT IOCAL SALES TAl(CODE IS�10D <br /> I hereby ceritity that I have read ard examined this applicatlon and know the same to be uue and conect. All provisions of laws and <br /> ordineces goveming ihis typN ef wurk wili be compliad wilh wlwlhcr cpccificd hcrcin or not.Tho granting of a perrc.it does rot pmsume <br /> to give authonry to violate or cancel th,provislon af any other state or local law regutating constn,ction or the perfortnenec of <br /> constmction.That I am authorized by the owner ot this property ta periorm the wo�ic for w'�ich npplicaGon is made aod I compty wllh the <br /> Sta�r:f.nntractnrs I aw 1R27 RCW and 296.200 WAC. <br /> �-r ��-a�� S'�9'� <br /> Signalure of Owner/ onvactonANhonzed AOent �a}P <br />