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[�3-17-' B5 13:24 FROP1-nw perrnit 13609452�91 T-677 PU02/003 F-662 <br /> ' PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEFETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—v:ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM � "a g� D l <br /> SITE AD�RESS PARCEL TAX I.D.tl PERMIT q <br /> 1319 LOMBARD AVE 00450625000900 ' <br /> LEGAL L0T NO, qLQ!.K TRACT <br /> DESG. <br /> OWNER ADORESS CITY2IP PHONE <br /> CECIL VESS 1319 LOMBARD AVE everett 98zo� 425 252-2042 <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> INaida Khan/Cyndal Millhoilin 360-945-2787 <br /> CONTRACTOR 1A/ESCO ADORESS CITYIZIP PHONE <br /> y° 2800 Thorndyke SEATTLE 800-398-Q663 <br /> CONTR.LICENSE4�A�ASHIES.9/ �OB <br /> VV <br /> USE OP BUILDING fiEAT SOURCE CONTRAC7 PRICE OF WORK <br /> residential _eie���� �Gas_Olhe� <br /> WORK DESCRIPT�ON <br /> REPLACE 40 GALLON GAS HU7 WATER HEATER @ SFR <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR�TEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel _ A/C—air handling units <br /> — Bathfub _ Forced air systems <br /> Lavalory(wash basin) ` Gas p�ping <br /> � Shower i Water heat..r <br /> Kitchen sink&disposal Gas fireplace <br /> � Dishwasher _ Gasrange <br /> Clolhes washer _ Clolhes dryer <br /> ` Laundry lray _ Range hood <br /> Sink(service/badmop/elc.) _ Exhausifan <br /> � Backflow prevanter _ Heat purnp <br /> Urinal Unit healer <br /> � Drinking Founlain ^ Boiler <br /> Floordrain � Re�r�geration <br /> � Grease lrap _ Woodstove <br /> Ro0(drains _ Oiher <br /> Other — <br /> CITY OF EVEFtETT LOCA�SALES TAX CD�E IS 3105 <br /> I here6y cenli(y that I have read and examined this application and know the same lo be true and correcl. All provisions of laws and <br /> ordinaces governing this type of work will be complied with wheiher specified herein or noL The granting of a permit does not presume <br /> to give authariry to violate or cancel the provision of any other state or local law regulating construction or the pertormance of <br /> construction.That I am aulhorized by tlie owner of this property lo pertorm the work for vfiich application is made and I comply vnlh the <br /> Stale Contr eto ^ Law 1027 RCW and 296.200 4VAC. ._..._._._.___.___ _.._._ <br /> _ � ��/Z�/v� <br /> �$ig atur EenlraCt �u onzed Agent mate • <br />