Laserfiche WebLink
P�tRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA�3201 <br /> 425-257-8810– FAX 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /fl ��J'— �� <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT# � <br /> � �'� S —h �� �� " ��� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION I <br /> DESC. <br /> OWNER ADDFESS CITY/ZIP PHONE <br /> I�� �,��� l,�/'c/ � ��, r3 � a b S �i1 l7��t I�GE �✓C.<��� <br /> TENANf NAME CONTACTFOR PERMIT �yHONE <�7r J 3,� -�d' J </ <br /> t✓PK II � S�.y /1o�,a/1 <br /> ��Jl! ✓� �� (��S-� JJ3G� GOr� /� E-MAIL � ffJTMa�II•fJ <br /> NTRACTOR ES 1 Y/Li��NbfIT�— <br /> CONTR.LICENSE 11 <br /> �Jn.�,�/ « < <I� K �- <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> —5�7-C—.�a � c _Electric �as_Olher .., a Q nOG `� <br /> WORK DESCRIPTION <br /> AL'IC;� r� ln-�i / I TU ?� G I G >'L FOS- S J OTG ,fj L' <br /> PLUMBING ME HANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet FUC-air h�adling unils <br /> �al.dub Forced��ir systems <br /> Lavatory(wash basin) - _ / Gas piping <br /> Shower Waler healer <br /> Ki!chen sink R disposal Gas(ireplace <br /> Dishwashcr Gas range <br /> Clothes washcr Clothes dryer <br /> Waler heater Range hood <br /> Sink(serv'ce/badmop/elc.) Exhaust(an <br /> Dacklbw prevenler Heal pump <br /> Urinal Unil healer <br /> Drinking Foun�ain Boiler <br /> Floor drain Refrigeralion <br /> Grease lrap Woodslove <br /> Rool drains Olher _ <br /> Olhcr <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 9105 <br /> I hereby cerili(y Ihal I have road and examined lhis applica�ion and know Ihe same lo be Irue and correct. All provisions o(laws and <br /> ordinaces c�overninc�this rype of work will be complied with whether specified herein or not.The granting o(a permit does not presume <br /> to give aulhorily lo violale or cancel Ihe provision of any other state or local law regulaling conslruclion or Ihe performance o( <br /> construction. That I am aulhorized by lhe uwner ot lhis property lo periorm lhe work tor which applicalion is made and I comply wilh lhe <br /> Slalc Contractors Law 18.27 RCW anJ 296.200 WAC. <br /> `��t:.w��� ���--t— �!J/5�/�' `I� <br /> Signawre of OwncdConlractoriAuthorized Agent Date / <br /> I� <br /> `-- — ---- – — — <br />