Laserfiche WebLink
I <br />PLRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />e <br />3200 CEDAR STREET, EVERETT, WA 98201 / <br />425-257-8810 — FAX 425-257-8857 — www.everettvvaj,irg <br />/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CADS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />5'3 uiiii Qlr►r VIf��Lr t)J <br />el -I I V;3- e"I G .71 ell 6eC <br />LEGA LOTNO. <br />BLOCK <br />TRACT <br />DES. <br />S I /C / D <br />�• /!� -c`O <br />/'1'7 //L��SS i2�Gd, :c` r.T �`rc y'Tns.�l.i)i.aY di"-�yfv Sic. r6r•3� <br />OWNER ADDRESS CITYIZIP PHONE <br />-),"= t c '1 ./YS / 4Ze, C <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # / �k <br />tSKI'p� <br />7- <br />USE OF BUILDING <br />v HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other <br />WORK DESCRIPTION 'k NW / <br />PLUMBING <br />MECHANICAL <br />NO. TYPE. OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_LG <br />Water healer <br />_Shower <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher - <br />',c: <br />Gas range <br />_ <br />_ <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other__ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have road and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give aulhonty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with file <br />State Contractors Law 18,,27 RCW and 296.200 WAC. <br />-_-,� SIC <br />Signature of Owne o^'-- Authorized Agent Date IL <br />i <br />