Laserfiche WebLink
rERMIT 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 ��a(� -Oq <br /> SITE ADDRESS PARCEI TAX I.D.# PERMIT p <br /> � � / i /� �(..k` ,`�, ' .. <br /> Z� 17,� C, �, �,� � � C' l� �'� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBOIVISION# <br /> DESC. <br /> OWNER ADDRESS CINfZIP PHONE <br /> .`_�,�!,jT�4L �zllC �.s; � ,� Z7c� � �/;y. �%.t �i�'�E'� / 7, �� '-�=' Z.7?-_ YDC <br /> TENANT NAME CONTACT FOR PERMIT PHONE 7 3 7 . �� J 7 S <br /> ' ♦ 7_. / L/ E•MAIL <br /> �. ii,LiiJ _S d I � �fi � �L <br /> TRA R AD R S I / IP N N <br /> CONTR.LICENSE f! <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �� C .5 / /} L< f' /jti' / — <br /> Eleclric _Gas_Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANlCAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toi�el A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) J Gas piping <br /> Shower Water hea�er <br /> _ Kitchen sink&disposal Gas fireplace <br /> Dishwasher � Gas range <br /> Clothes washer Clothes dryer <br /> Waler heater Range hood <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> BackOow preventer _ Heat pump <br /> Urinal Unil heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeretion <br /> Grease lrap _ Woodslove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify Ihat I have read and examined lhis application and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied wiUi whelher specified herein or not.The granting o(a permit does nol piesume <br /> lo give authonty lo violale or cancel the provi5ion o(any other state or local law regulaling construction or the performance ol <br /> conslruction.That I am aulhorized by the Uwner of lhis property to perform lhe work for which applicalion is made and I comp�y wilh the <br /> Slat�,EonlractoLrs,Law 1ty.27 RCW and 296200 WAC. � <br /> i/rl���(r ' C�-:L'.�i.�t.L'�/`� V'V;�'c_�� /���J I <br /> Signature of OwnedConlraclouAulhonzed A�ent Dato — � <br />