Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />LEGALF LOT NO. BLOCK TRACT O SUB��D�I//VyISION 0 oo -y/, ��// /„ <br />DESC. ." dQ Kli��tY'1 kom. / �.Ilfi(u ���a ( �r k <br />OWNER ADDRESS CITYIZIP PHONE <br />u-I l I i filA/Sly Leann - ,205-.2 ! 36&1 <br />TENN,ANNTNAMECONTACT FOR PERMIT y 3&^ Q .C•) k PHONE(/23-,f,3u .Z 941' <br />V`F/r'C��n C l"rrl�tl LPS Cl1dA! d y'a ;c- E-MAJLle5-4P5e a -hi((, A. <br />CONTITXMHlUro - a.'firerc ADDRSS ONE <br />y/O gvlf 15� Stu q &e'r f tvA &?9. c3 <br />CONTR. LICENSE htL n C-NC, / -,O' 3, ` 4� r_.2f� —(,/1 e2 <br />--f <br />U OF BUILDING /` (n HEAT SOURCE y� CONTRACT PRICE OF WORK <br />//Q'' Electric _Gas ther <br />WORK DESCRIPTION A,/a f}�0(',,^i� / 6or lit�i�r.�r✓c /ilS� (y1e l �1^r CL L e <br />�n _r vealf jQh.,rj �Ict(t1a <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />_ Toilet _ A/C - air handling units <br />_ Bathtub _ Forced air systems <br />_ Lavatory (wash basin) _ Gas piping <br />Shower _ Water heater <br />Kitchen sink 8 disposal _ Gas Neplace <br />Dishwasher _ Gas range <br />Clothes washer _ Clothes dryer <br />Water heater Range hood <br />Sink (servicebar/mop/etc.) Exhaust Ian <br />Backflow preventer Heal pump <br />Urinal I Unit heater <br />Drinking Fountain v __ Boi!dr <br />Floor drain Refrigeration <br />Grease trap �� Woodstove r <br />Roof drainsn`.Other_ IIiG v, SA. <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 „rK • ur <br />1 hereby cerilify that I have read and examined this application and know the same to he true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulat.ng construction or the performance of <br />construction at I am autho fired by Ih owner of this properly to perform the work for which application is made and I comply with the <br />State C rat rs L. 18 CW 96.200 WAC. <br />Sign re o OwneriContraclor Aulhonz gent Date <br />t l <br />