Laserfiche WebLink
fran: 03/1R/2008 09:18 tt024 P.002/002 <br />PEi�MIT �PPLICATION 39'8'Z <br />��i��CITY OF EVERET � PERMiT SERVICES <br />..,,, 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 3_� �,0� <br />425-257-8857 FAX � <br />SITE AODRESS PARCEL TAX I.D.# t'ERMIT# <br />3532 LOM[3ARD AVE, EVERETT, WA 9820I 00438185602100 <br />/��r -7 � <br />� V �1.:> L; � . <br />LEGAL LOT NO. BIOCK TRACT <br />OWNER AODRESS PHONE <br />Kf2ArT,KIMBERLY 3522LOMBARDP.VG (425)259-1702 <br />• EVERETT, WA 98201 <br />TENANT NAME CONTACT NAME PHONE <br />MOM-DIANH Carol Randall B00-454-8955 x 133 <br />CONTRACTOR ADDRESS CONTR.LICEkSE# <br />rASTWATERHEATfiRCOMPANY 1260] 132NDAVGNG �ASTWWH948DC <br />800-454-8955 KIRICLAND, \VA 98034 O1/04/ZO10 <br />Buildtnp Meehanfea WORK Additlon <br />PROPOSED USE OF BUILDING HEAT SOURCE <br />PERMIT Combinallon Piumbinp Altaration ElectAc <br />IYPE Dumoliflon Slgn T�PE Now ac <br />r Re alrlMalnt ther <br />CONTRACT PRICE OF WORK S449.00 CITY OF EVERETT LOCAL SALES TAX COOEIS 3�05 <br />WORK DESCRIPTION Removc/Repince Gas Watcr Hcater <br />PL.UMBING MECHANICAL <br />NO. TYPE OF FIX7URE OR ITEM NO. TYPE OF IXTURE OR ITEM <br />__ WAT[R CLOSET _____ A/C-A/HANDLING UNITS <br />___ BATHTU9 ___ FORCED AIR SYSTEMS <br />_ _, LAVATORY (WASH BASINj ,_�_ HEAT PUMP <br />___ SHOWER ___ UNIT HERTERS <br />___ KITCHEN SINK 14 DISPOSAL ^__ CIOTHES DRYER <br />___ OISHWASHER RANGE HOOD <br />�_ LAUNDRY TRAY _ _l� WATFR HEATER <br />� CLOTHES WASHER __ METAI. FIREPLACFJSTOVE <br />_ URINAL _�_ FIREPLACE INSERT <br />� ORINKING FOl1NTAIN _ GAS FIREPLACE <br />_ FLOOR DRAIN GAS RANGE <br />__ BACKFLOW PREVENTER ___ GAS PIPING <br />___ SINK (SERVICElBAR/MOP/ETC.) ___ EXHAUST FAN <br />__�_ OTHER _ ____ OTHER_________��__T <br />i---- ---- — ---- —'--- -- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APL�CA710N AND KNOW THE SAME TO BE TRUE AND CORRECt All <br />PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WI� ! BE CUMPLIEO WIHT Y�HETHER SPECIFIEO NERE! <br />OR NOT. THE GRANTING OP � PERMIT DOES MOT PRESUME TO GNE AUTHORII Y TO VIOLATE OR CANCEL TNE PROVISION OF ANY <br />OTHER ST�TE OR LOCAL LAW REGULATING CODJSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THqT I AM AUTHORI2ED <br />BY THE OWNER OF Tfil:; PROPERTY TO PERFORM THE WORK FOR WHICH APPLICRTION IS MAOE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW tl/.27 RCLV AND 296200 WAC. <br />signaturo of OwnorlContrrcP.orlAuthorizod Agont ����a���,,��P Date 03/18/2008 <br />� <br />ui on� <br />