Laserfiche WebLink
U3-��-' 11 96:45 FROf`1-nw permit 13609952�91 T-`l'30 P002/003 F-711 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S7REET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM II AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT# <br /> 1015 LOMBARD AVE 29051700204500 � � "� <br /> 6EGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> TIM MOTT 1015 LOMBARD AVE Everettsszol 425-329-4510 <br /> TENANY NAME CONTACT POR VERMIY PHONE <br /> INaida Khan 360-945-2787 <br /> CONTRACTOR �A/ESCO Aoo:tfiSS �CITVIZIP PHONE <br /> V V 2g00 Thorndyke SE,4TTLE 800-398-4663 <br /> CONTR.LICENSE k Il1l A SI..I I�s`9'7��g <br /> V V/'1 I <br /> USE OF BUILDING I — HE/+T SOURCE I CONTRACT PRICE OF WORK <br /> SFR Elsctric �,Gas_other $950 <br /> WORK DESCRIPT�ON <br /> REPLACE GAS WATER HEA7ER. <br /> PLUMBING MECHANICAL <br /> NO. TYFE OF FIXTURE OR ITEM NO. 7YPE OF FIXTURE OR ITEhi <br /> Toilet _ FVC-8ith�ndlingunils <br /> Bathlub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> � Shower � Water heater <br /> Kitchen sink&disposal _ Gas iirep!ace <br /> � Dishwasher Gasrang� <br /> Clolhes washer _ Clolhes dryer <br /> � Laundry tray _ Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaustfan <br /> - � BackOowprevenler _ Heatpump <br /> Unnal _ Unil heater <br /> orinking Fountain _ Boiler <br /> FloOfdrain _ Re(rigeration <br /> Grease trap _ Woodslovo <br /> Roof drains _ Olher <br /> Other — <br /> CITY OF EVERETT LaCAL SALES TAX CO�E IS 7105 <br /> I he�ctby cerilify lhal I have read and examined lhis application and know lhe same lo be Uue and cor�ect. All pmvisions of laws 2nd <br /> ordinaces goveming this type Of work will bu complied wilh whethe�speci(ied hsrein or not. The gran�ing of a ponnit does not presume <br /> to give authority to viol2te or cancel lhe pmvision of eny olhor slata or Ixal law regulating consWction or the pedormance o( <br /> construetion.That I am aulhorized by lhe owner o(this properly to peKom��he work for which applicallon is made and I comply wilh the <br /> State Conlraclors I 18�7 RCW and 298.200 WAC, <br /> 3/�/2or� <br /> Siflnatuf¢of Owner CenlractodA orized ent Date <br />