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SITE ADDRESS <br />5519 EAST DR <br />LOT NO. <br />DESC. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — wwvu.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />00471700001002 <br />TRACT <br />PERMIT # <br />�ll� 5- c�-t`� <br />JIM BERGMAN SAME AS SITE ADDRESSS Everett9+32o� 425-344-7305 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />INaida Khan 360-945-2787 <br />CO�iRACTOR 1A/ESCO <br />�� <br />CONTR. LICENSE N WASHI ES97� OB <br />USE OF BUILDING <br />SFR <br />WORI< DESCRIPTION <br />ADDRESS QTY21P PHONE <br />2800 Thorndyke SEATTLE 800-398-4663 <br />HEAT SOURCE <br />_ Electric � Gas_ Other <br />replace gas tankless hot water heater w/ 20' gas piping <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basln) <br />Shower <br />Kitchen sink & disposai <br />DisMvasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbadmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasetrap <br />Roof dralns <br />Other <br />CONTRAGI h'Fcictvr vv�r�r. <br />3166.00 <br />NO. I TYPE OF fIXTURE OR ITEM <br />A/C — air handling units <br />Force�i air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />6chaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstwe <br />Othet <br />� <br />C17Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritity that I have read and examined this application and hnow the same to be true and correct. All prwisions oF laws and <br />ordlnaces governing thistype otworkwill be complied with whether specilied herein or not. The granting ot a permit does not presume <br />to give authoriry to violate or cancel the provision of any other state or local law regulating construction or the pertormance of <br />construdion. That I am authorized by the owner of this property to perform the work for which application is made and I compty with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />.,-� '�.-_ 5/12/11 <br />Signature of Owner/Contractor/Authorized Agent Date <br />