Laserfiche WebLink
— � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N P�ER/MIT N <br /> ��J �2- W��R-� I L.Y,inf/J � <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> B�car�S c-�c 4z�9 �(€ � B�1u�c�►, a9zzs 3r.o ���-a3g <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> V�S(T1fSG �I'15Ci�5 I TKF� G L�kt3� 3G0 (.�1-83YSi 3Ge 3o3-S6r`� <br /> CONTRACTOR W((�Lf�s ADDRESS CITY2IP PHONE <br /> Sc�SR,c� t 4�+0� auaK�f wK ►wo 3w �Si-18� <br /> CONTR.UCENSE N MK�Y3UII.L,�. <br /> �4��r��l <br /> USE OF BUILDING I HEA SOURCE I CONTRACT PRICE OF WORK <br /> �"�a�'Y °�"� �Electric Gas Other <br /> WORK DESCRIPTION .�-�,1�a�Y /� <br /> ���C' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilel A/C-air handling units <br /> _ Bathtub Fcrced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gasrange <br /> _ Clothes washer Clolhes dryer <br /> Waler he:ler Range hood <br /> _ Sink(sen�calbar/mop/elc.) Exhaust fan <br /> _ BackOow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Otlier <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby cenlify lhat I have read and examined this application and know Ihe same to be true and cortecL All provisions af laws and <br /> ordinaces governing this type of work will be complied with whelher specified herein or not.The granting of a pertnit does not presume <br /> to give aulhority to violate or cancel the provision oi any ather state or Iocai law regulaling constructlon or the perfortnance of <br /> constructio That I ani authorized by the owner of this property to periorm tho work for which application is made and I comply with the <br /> State Con tors aw 8.27 RCW and 296.200 WAC. <br /> � ,2 2ao� � <br /> SignaWre of OwnedContractor/Authonzed Agent Date ��Z <br />