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r.. r_ � ° •,. o ao. +.ou.¢o o+ u000 .Door. � 000.000aua r.o...- o•.ee.... sw•.m. <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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. 0 PERMIT 0 ' I <br />I-I05-0 3 <br />2030 SUMMIT AVE 00563240903100 _ I <br />LEGAL LOT NO. BLOCK TRACT <br />DESC <br />OWNER ADDRESS CITY/ZIP PHONE <br />ZEB W COLLINS 2030 SUMMIT AVE Everelt 98201 425-244-0313 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />JENNIFER COVELLO 206-774-9499 <br />CONTRACTOR ,^ rESCO ADDRESS CITYIZIP PHONE <br />VV J 3909 196th St SW Lynnwood 800-398-4663 <br />CONTR LICENSE. WASHIES9710B <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Res <br />_ Electric V—/ Gas _ Other <br />950.00 <br />WORK DESCRIPTION <br />REPLACING GAS WATER HEATER <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />_ <br />AJC — air handling units <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />+_ <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (servicelbarlmoplelc.) <br />_ <br />Exhaust ran <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boller <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerdify that I have read and examined this application and know the same to be true and correct All provisions of laws and <br />ordinaces governing this type of work unit be complied with whether specified herein or not The granting of a permit does not presume <br />[o give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />censtructwn. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 29f�.24�,y,�iA&i!.°�,.l,cmna <br />Jennifer Covello °°m.k°'°`°w'°°°a'°°°°° <br />MA.- rMa,:wwpimcmm.!•V1 <br />->n trio nv ror+n+ro <br />Signature of OwneUContractor/Authorised Agent Date <br />