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�. <br /> Fi4-19-'10 10. 00 FROM-nw pei•mit 136D9452091 T-159 P�02/002 F-359 <br /> �- PERMIT APPLICATI�N !-� <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEC.�R STREET, EVERETT, WA 98201 i <br /> 425-2�7•8810 — FAX 425-257-8857 —Nnrnv.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM LI�I 9—/I� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI7# <br /> 1801 LOM6,4RD AVE 0043823G400100 �l'�� ��_��r <br /> LEGAL LO7 NO. BLOCK 7RACT <br /> DESG. <br /> OWN[R A�DRESS CITYIZIP PHONE <br /> KEITH ANDERSON 1801 LOMBARD AVE Everetl96201 425 252-2851 <br /> T[NANTNAME CONTACTFORPERMIT PHONE <br /> Naida Khan 360-945-2787 <br /> CONTRACTOR �p/�JCO aooaess cirv�z�� PHONE <br /> �� 2800 Thorndyke SEATTLE 800-398-4663 <br /> (:ONTP..LICENSE#1�lASHIES9l �OB <br /> vV <br /> USE OF BUILDING HEAT SOl1kCE CONTRACT PRICE UF WORK <br /> SFR I _Electric �Gas�Other $950.00 <br /> WORK DESCRIPTION <br /> R[PLACE 50 GALLON GAS WATER HEATER <br /> PLUM6ING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIX7URE OR ITEM <br /> Toilet A/C-air handling uni(s � <br /> Bethtub � Forc�:d air syslems <br /> J Lavalory(wash b25in) Gas piping <br /> Shower + Waler heater <br /> � Kitchen sink&disposal Gas freplace <br /> Disl�washer Gas range <br /> . _.... ...--:—,_�1:lolhes_w3sllef::�_:'-�-�--.-.-:--�-----._...,,;__..__... ;_-:. . — Clofhes �[,_-.._. . . ...::�-�.::� ------ <br /> .__ ----��1TTa� -----.._. . --.._ _ _ �Renge�hsed__ . __-_- <br /> ---- --— — ----- <br /> _ Sink(servica/badmop/eta) --�---�--.... .. . . . __ . .EicfiausC(an . .... . . . . .....------...�_ .. <br /> BackAow preventer Heat pump <br /> � Urinal Unit haater <br /> Drinking Fountain Boiler <br /> Fioordrnin � Refrigeration <br /> Grease lrap Woodstove <br /> koof drains OU�er <br /> Olher <br /> CIiY OF EVERETY LOCAI SAIES TAX COOE IS 1105 <br /> I hereby ceritify ihat I have read and examined�his application and know the same to be true and correcL All provisions of laws and <br /> ordinaces governing this rype of work wiu he wmplied�vilh whether specifed herein or not The grantirg of a permit does not presume <br /> to give 2ulhotiry to violate ar cancel the provision of any other st2le or local law regulaG�g construction or�ha periormance of <br /> consiruction That I am aulhorized by the owner of�his property to perform Ihe work for vfiich appiication is mede and I compiy w�th the <br /> State Cont ac s � "fQ27 RCW antl 296.200 WAC. <br /> Sgnature o( vm r/'ortlractor ulhonze Agent � � D t� v <br />