Laserfiche WebLink
To: Permit Services Page 2 of 4 2015-12-31 03:47:55 (GMT) 18884000383 From: Deborah Shields <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.# PERMIT# <br /> 5702 LOMBARD AVE 00544701200102 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DE! . <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> JAMES H POLLOCK 6702 LOMBARD AVE Everett 98203 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I-Nalda Khan 360-945-2787 <br /> CONTRACTOR Washington Energy Svcs Co, LLC ADDRESS CITY/ZIP PHONE <br /> 3909 196th St SW Lynnwood 800-398-4663 <br /> CONTR. LICENSE#WASHIES851 NS <br /> USE OF BUILDING V L 1 V HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _Electric V/—Gas_Other $950.00 <br /> WORKDESCRIPTION <br /> REPLACE GAS WATER HEATER. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO, TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower t Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceritify 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 will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state 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 for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> '. Digitally signed by Naida Khan <br /> hl a i�I a Khan DN:ui=Naida Khan,o=Nortlivoest Permit <br /> Signature of O n r o /A t ri bbie:z015.l2 3e 19ah:n-087 a e <br /> s <br />