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t <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.everetivva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S`'� o�'''I� <br /> SITE ADDRESS PARCEL TAX I.D.11 P RMIT# <br /> 4831 FOWLER AVE 00394600002600 � — �1 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 Q7Y21P PHONE <br /> RODNEY HOYLE SAME AS SITE ADDRESSS Evereu s8zo3 425-259-3608 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I Naida Khan 360-945-2787 <br /> CONTRACTOR \A/ESCO ADDRESS dTY21P PHONE <br /> �� 2800 Thorndyke SEATTLE 800-398-4663 <br /> coNrR.uceNse a WAS H I ES971 OB <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> SFR I _Electr(c �Gas_Other 9�j0.00 <br /> WORK DESCRIPTION <br /> REPLACE GAS 50 GALLON HOT WATER HEATER <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTUREOR ITEM <br /> Toile[ _ A/C—alr handling units <br /> Bathtub _ Forced alr systems <br /> _ Lavatory(vrash basin) _ Gas piping <br /> Shovmr � Water heater <br /> Kttch=n sink&disposal _ Gas fireplace <br /> Dish�vasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/bar/mopletc.) _ Exhaustfan <br /> Backflowpreventer _ Heatpump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain Boller <br /> Fioor tlrain Refr(geration <br /> Grease trap _ Woodstwe <br /> Roof dtains Other <br /> Other <br /> q7Y OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby cerRity that I have read and examined thls application and knowthe same to be true and correct. All prwisions of laws and <br /> ordinaces governing thls type of work will be mmplled with whether speclfied herein or not.The granting of a permt does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the pertormance of <br /> construction. That I am authorized by the owner ot this property to pertorm Ihe Hrork for whkh appllcation is made and I mmply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> !�, <br /> Ti' 't�� <br /> S gnature o neqContractor/Authorize Agent ate <br />