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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES q <br /> 3200 CEDAR STREET, EVERETT, WA 98201 55� <br /> 425-257-8010— FAX 425-257-8857—www.everettwa.org N <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _a 6-a7 <br /> SITE ADDRESS PARCEL'�AX I.D.# PERMIT# <br /> 1731 Lombard Ave 00438235101500 MU�oa-�`� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AD�RESS CITY/ZIP PHONE <br /> Rosie Downing 1731 Lombard Ave Everett 98201 425-259-1023 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> IMelissa Croda 36�-945-2787 <br /> CONTRACTOR �A/ESCO A�DRESS CITYIZIP PHONE <br /> �� 2800 Thorndyke SEATfLE 206-378-6649 <br /> CONTR.LICENSE# �A/ASH I ES971 OB <br /> VV <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR Electric �Gas Othcr 75�.�� <br /> WORK DESCRIP7ION <br /> Replace gas to gas 50 gallon 40,000 btu 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 /> 6athtub Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower i Water heater <br /> Ki�chen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhos washer Clolhes dryer <br /> Laundry Iray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backfiow prevonler Heat pump <br /> Urinal Unil heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> = Other _ _I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify tha� I have read and examined this application and kno.v Ihe same lo be lrue and correcL All provisions of laws and <br /> ordinaces governing lhis type oF work will be complied�vith whether specified here'n or not.The granting of a permil does not presume <br /> to yive authority to violate or cancol the provision of any other state or local law reyulating consiruction or the performance of <br /> conslruction. That I am aulhorized by the owner of this property lo perform the work for which application is made and I comply wnh the <br /> Stale Conlraclors Law 18.27 RCW and 296.200 WAC. <br /> T �x� —.=1 a3 7 <br /> Signalure o(OwnedCoNraclor/Authorized Agenl Date <br />