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i � <br /> PERMIT 4PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8B10—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I � �'�"� 7 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT� <br /> 211'I LOMBARD AVE 00439143900600 � �-�;,- <br /> LEGA LOTNO. 9LOCK TRACT . <br /> DE£C. <br /> OWNER 4DDRE55 CITY2IP PHONE <br /> JESSI�:.� RUUTH 2111 LOMBARD AVE Evcrctt9szot 425-9.43-7703 <br /> TEMANT NAMI: CONTACi FOR PERMIT PHONE <br /> Naida Khan 360-945-2787 <br /> CONTRAI:TOR �11/�SCO AO�RESS CITY2IV PHONE <br /> CONTRIICENSE/ 2800 Thorndyke SEA'i-fLE 206-378-6649 <br /> WASHfES971 OB <br /> 118E OF IBUILDING HEAT$OURCE CUNTRACT PRICE OF WORK <br /> SFR _e�ectdc � �as_other 4383.10 <br /> —_ _... _.._ . <br /> WORK DE5CRIPTION <br /> Replaoe oil to gas 80,000 btu furnace <br /> PLUMBING MECHANICAL I <br /> N0. 7Y�E OF FlICTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM � <br /> Toilet A/C—air hanQling unib <br /> Bathlub i Forcedairsyslems . <br /> , Levatory(wash 6asin) � Gas piping <br /> 917owar � W2t2�h2dtef <br /> _ Kitchsn sink&disposal Gas fireplaa: <br /> Oishwasher Gas range <br /> CIuU�es washei Clolhes dryer � <br /> Laun9ry tray Range hood <br /> � Sink;service/badmop/etc.) � Exhaustfan <br /> Bock`.1aw preventer Heat pump <br /> Urinal Unit heater <br /> prinking Fountsin � Boiler <br /> I-loor drain Rafiigont�on <br /> Grease trep Woodstove <br /> Roofdrains Other <br /> Other — <br /> CITY aF EVERETT LOCAL SALES TlVC COOE IS J106 <br /> I hareby ceritify that I have read and examined this application and know the same to be true and corcect A�I provisions of iews and <br /> oMinaoc�govcming tMo typc of vrork wlll bc oomplicd with whUhcr�pecifi�tl herc�r or not.7he gmnL'ng of o permit doea not preaume <br /> to give authority to violate or cancel the provision of any other state or lacal Ww regulating wnstruction or the pedormance of <br /> consWction,That I am authonzed by the owner of this property to perform the work for which application is made antl I comply with the <br /> Statn�,'ntradoro L. 1827 RCW and 29&.200 WAC. <br /> �`'� (0�03�6�- <br /> Siqnature ot er/ContradodAuthor¢e�c qent Dale <br />