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5612 LOMBARD AVE 2016-01-01 MF Import
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5612 LOMBARD AVE 2016-01-01 MF Import
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Last modified
5/10/2017 12:35:33 PM
Creation date
2/17/2017 8:50:19 PM
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Address Document
Street Name
LOMBARD AVE
Street Number
5612
Imported From Microfiche
Yes
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SITE ADDRESS <br />LOT NO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />42Fi-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. # <br />� �`'�rY/i9f7- Sl��% L c�+l!Ja��'/ <br />78 CONTACT FOR PERMIT <br />CONTRACTOR <br />CONTR. LICENSE # <br />USE OF BUILDING <br />WORK DESCRIPTION <br />�"!��'I C'h� <br />�Ln <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />ShoHer <br />Kitchen sink & disposal <br />Dishwasher <br />Glolhes washer <br />W ater heat�r <br />Sink (service/badmop/efc.) <br />BackOow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />ADDRESS <br />HEATSOURCE <br />Electric Gas Other <br />GC1� <br />CITY2IP <br />� �as _o <br />PHONE <br />CONTRACT PRICE OF WORK <br />MECHANICAL <br />TYPE OF FiXTURE OR ITEM <br />AIC — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gasrange <br />Clathes diyer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SAI.ES TAX CODE IS 3105 <br />I hereby cerili(y that I have read and examined lhis ap��iicalion and know lhe same lo be irue and correcL All provisions of laws and <br />crdinaces c�oveminy this type of work will Se complied wilh whether speci(ied herein or nol Tho grantiny of e permit does not presume <br />lo c�ive authority to violale or canr.el Rie provision of any olher stale or loca! law reyulaling construction or the peiiormance of <br />conslruclion. Thal I am aulhorized by the owner o( this property to perform lhe work for which application is made and I comply wilh the <br />Slate Contrac!ors Law 18.27 RCW and29�.200 WAC. � / <br />r <br />
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