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' ' APPLI�CQ'"ION FOR CONSTRUCTIOf�'-�ERMIT� <br /> ' CITY OF EVERETT. BUILDING DIVISION <br /> 3200 CEDAR STREET.EVERETT,WA08201.257•8810 <br /> ❑ DEMOLRION � COMBINA710N ❑ BUILDING ❑ MECHANICAL 0 PLUMBING ❑ SIGN <br /> PROJECTADDRESS <br /> 2508 LOMBARD AVE Everett WA 98201 <br /> ONNEN MNL�WPE55 GiY :.IV VIqNE <br /> Carol Clark 2508 Lomberd Ave Everett 98201 4252581151 <br /> TCNANi M.VLM1[NME54 Gtt }6 PIV'4E <br /> <Narti9> <Add�ess> <Cily> <Zip> <PhOne> <br /> Mp111ECfONDE5IGNEN Y4L�CONE55 G1V II' %qHE <br /> <Name> <Address> <Citv> <Zio� <Phona> <br /> GEHEPALCOMMCIOP MIJLMOXE55 G'Y LV PM1p.£ 4.•Li96•:.c• <br /> Fasl Water Healers Ccmp 12601 t32nd Ave.N.E. Kirkland 98034 4258143124 FAS f�^driC052DF <br /> uCC�V.NiUtfANiqACiOR MMIDDRESS CIiV IW pNONE S1AlEJCE':aE� <br /> <Name> <Address> <Cily> <Zip> <Phone> <Lic No> <br /> RV44NGCONIRACLOfl AWLAppFE55 G1Y IN FINM+E ST�RULENSE• <br /> <Neme> <Address> <Cily> <Zip> cPhane> �Lic NO> <br /> carrtw.crrac¢wwonK <br /> 349.00 HEATING SYSTEM: ❑GAS❑ELECTRIC ❑_ <br /> CESCPIBE WOR✓.N�OSCV 41EfCOiAGE W V0.VE� LONiACTRN50M MIO P1qNElq. <br /> Remove/replace electric waler heater cNAME> <br /> <PHONE> <br /> I HEREBY CERTIFY TMAT I HAVE READ AND EXAMINED TMIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> >noroscouSEor aundxc PROV:SIONS OF LAWS ANO OROINANCES GOVERN.NG THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETMER SPECIFIED H[REIN JR <br /> NOT. TME GRANTING OF A PEF:AI'DOES NOT PRESUME TO GIVE <br /> iceuoescaianaeorrnoacnrv�swwHeeiowonnnecntwocones� AUTHORITV TO VIOLATE OR CANCEL TME PHOVISION OP ANV <br /> ior_____e�onc_._or__ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSiRULTION.THNT I AM AU7HOftIZED BV THE <br /> — ON'NER OF THIS PROPERTV TO PERFOftM THE WORK FOR WHICM <br /> APPLICATION IS MADE AND I COMPLV WITH TME STATE <br /> w,pce�rexi p.nuuecx CONTPACTORS LAW 78.27 ROW AND 296.200 WAC. <br /> cousrnunronio.wi[xo[n..00ncss.rcicv�wr�enuueen X � 03/09/2001 <br /> <Name> <Address> sicr+nruaE onre <br /> <Cily> ST <2ip> <Phone> CITY BUSINE55 LICENSE NO. <br /> PLUMBING MECNANICAL <br /> NO. TYPEOFFI%TUREORREM F� Np. TYPEOFEOUIPMENT F� <br /> WATERC�OSh7 OILE P1C-qMNDLGUNITS <br /> BATHfUB FORCEDAIRSY5fEM5 <br /> LAVATORV lYASH BASIN HEATPIIMP <br /> SIION'ER UNRHEATES <br /> KRLNENSIMK8015P CLOTHESORYERS <br /> DISHWASHfR RANGEHOO� <br /> tAUNDRYTRAY 1 WATE4HEATER <br /> CLOTHESIVASNER WOODSTOVE <br /> UftINAI. MEfALPIkEPIACE �BURNING <br /> IX31NK:NGFWIRAIN FIREPLACEINSERT DBIIRNING <br /> FLOORUfiAIN GlSFIREPtACE <br /> BACKFLCW PREVEMEHS GAS RANGE <br /> SINH SERVICE�BAR,EfC. GASPIPING <br /> EXNAUSTFAN <br /> SUBTOTAL 5 O SUBTOTAL S 0 <br /> f47d.vi 5 PBA1ff S <br /> TOTALFEE 5 v 70TALFEE S O <br /> FOR OFFICE USE ONLY: <br /> (Pq1i5EiBAGf flWISETBACN Si0E5EtpKlt N R.L�DMBEq� fCE NECEIVLNp, <br /> 3 <br /> us[ior+e mru�u veuvrSrtE FEES VALUATION FEE <br /> ores ur�a eunn:uc <br /> Nccnruwr�rox xo.orowc�ur+c s�ore�nr✓ri. <br /> uni*s vwueiva <br /> pCCOvµCv NO.(ISIOWESCLCUe.WILOAO BKEYENL ME6'M1CAL <br /> LFOUV <br /> OVE$ ❑NO. <br /> fIFESGNINqEflflE�D PfA5d1 MdiIOP4>WICNECN <br /> OiNER <br /> fIPE/.VAMPEOD R[h5W <br /> StU[BUIIHNG SUNCNAPOE <br /> ttveorcaxsr. wwsi,wnrnwar CITYOFEVERETT rueucwoaKs <br /> LOCALSALES <br /> y,r,- TAX CODE IS 3105 TOTAL <br />