Laserfiche WebLink
P�RMIT APPLICATIGN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org ��� �7 � <br /> / � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> i�yr4 14�� �� SE �rAlolA �o��u7vn� orb o Boso�-oN� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> �����J�,;, (�Q(cPw�a� �(� .6�X 1d59 Snu�w��'sl.. 'rlg29i �{ZS 33�/ SOfP <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR M4vUSVIII� YIU��''� �'w ADDRESS CI1Y21P y2 PHONE <br /> CONTR.LICENSE# `I�r�nQ�/SQ�I'Ipl�'� �33� � �'�� �f'In9�eln '%� 3 36o y35 SSSS <br /> f'1�l I i.l <br /> USE OF Billi_DING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> / Toilet _ A/C—airhandlingunits <br /> Bathtub Forced air systems <br /> Z Lavalory(wash basin) Gas piping <br /> Shower � Waterhealer <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Laundry lray _ Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease lrap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 9105 <br /> I hereby ceritify that I have read and examined this applicalion and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing lhis type of work will be complied with whether specified herein or not.The granling of a permit does not presume <br /> to give authonty to violate or cancel lhe prcvision of any other state or local law regulating construclion or the performance of <br /> construction.That I am authorized by lhe owner of this propeAy to perform lhe work for which application is made and I comply with the <br /> Stale Co r ctors Law . RCW and 296.200 WAC. <br /> ,�1.�._ 7�9�is' <br /> Signa ure of OwnedConlrecrodAuthorized Agent � Date <br />