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12-28-'07 16:04 FROM- T-025 P002/002 F-102 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 -FAX 425-257-8857 - my v.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. a <br />PE MIT # <br />5026 27TI-I AVE W <br />29043400403500 <br />LEGALF LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITYIZIP PHONE <br />JAMES KLICPERA 5026 27TH AVE W EVERETT.98203 425-353-7779 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Naida Khan 360-945-2787 <br />CONTRACTOR WESCO ADDRESS CITY/ZIP PHONE <br />2800 Thorndyke SEATTLE 206-378-6649 <br />CONTR. LICENSCtt WASHIES971 OB <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE 17F WORK <br />SFR <br />_ Electric V—( Gas —Other <br />750.00 <br />WORK DESCRIPTION <br />REPLACING GAS TO GAS BRYANT 80K BTU FURNACE <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C— air handling units <br />Bathtub <br />t <br />Forced air systems <br />_ <br />^_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water healer <br />_ <br />Kitchen sink R disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />Sink (service/bar/mop/etc.) <br />�_ <br />Ertiaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />T <br />Drinking Fountain <br />Boiler <br />Floor drain <br />J <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby coritify Ciat I have read and examined this application and know the same to be tore and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violare or cancel the provision of any other stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work or which application is made and I comply with the <br />State Contr. ctors Law 18.37 RCW and 29C200 VVAC <br />Signature of Owner/ f raclorlAulhorized Agent 1 le <br />