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PERMIT APPLICATION g � 3 <br /> CITY OF EVERETT PERMIT SERVICES 3 rJ � <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 �f —/6 ..D6 <br /> SITE ADDRESS PARCEL TAX I,D.# PERMIT p <br /> 4809 Colle e o06o690oa002oo � <br /> LEGAL LOTNO. BLOCK TRACT ' <br /> DESC. I_OT Z BLK o04 D-00 VISTA HEIGHTS ADD <br /> OWNER ADDRESS CITY21p PHONE <br /> Patti ,�rmiston 4809 College Ave Evarett 98203 425-252-7161 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> IMelissa Croda 360-945-2787 <br /> CONTRACTOR �A�ESCO ADDRESS CfTYILP PHONE <br /> �� 2800 Thornd ke SEATTLE 206-378-6649 <br /> CONTR.IICENSEM WASHIES9�I1 OB y <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _e�a�c�+� ✓ Gas �ther I 950 00 <br /> WORK DESCRIPTION <br /> Replace Gas to Gas 50 Gallon Water Heater <br /> PLUMBING MECHANICAL <br /> y�• TYPE OF fIXTURE OR REM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilot A/C—air handling units <br /> _ Belhtub Forced air systems <br /> _ Lavatory(wash basin) Gas p(ping <br /> _ Shower i Waterheater <br /> _ Kitchon sink 8 disposal Gas fireplaco <br /> _ Dishwasher Gosrange <br /> ,_ Clothes�vasher Clothes dryer <br /> _ Laundry tray Rango hood <br /> _ Sink(service/bar/mop/etc.) Exhaust fan <br /> _ Backflow prQvoNer Haal pump <br /> _ Unnal Unitheater <br /> _ Orinking Fountain Boiler <br /> _ Floor drain Refrigeretion <br /> _ Grease trap Woodstove <br /> _ Roof drains Olher <br /> Olher — <br /> CITY OF EVEREiT LOCAL SALES T/U(CODE IS 3105 <br /> I heroby ceritify thal I have read and oxaminod this appiicalion and know Ihe same to bo trua and correct. All provisions of laws and <br /> ordinaces goveming this typa of work will be complied wilh whether specified horein or noL Tha granting of a pormil does nol presume <br /> to give authoriry to violale or cancel the provision of any other state or local law regulating construction or the performance of <br /> construclion. That 1 am authorized by Ihe owner o(this property to pedorm lhe wo/k tor which application is mado and I comply with tho <br /> Stato Contractors Law 16 27 RCW and 296.200 WAC. <br /> � 1�,� �,� �i//� /h <br /> SignaWre ol wneNCoNractor/Authorized Agont �ate <br />