Laserfiche WebLink
-03 -� <br /> P�RMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9b201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / <br /> SITE ADDRESS � PARCEL TAX I.D.p P,€R.�IIT ll � <br /> l �;j�si C,, s, .,a i'��� � � i Z-'���1 /_'.<^ci�i �-/n.c, {� u'v � <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDNESS CITY2IP PHONE <br /> L��iCl� lilr,ifl.�, L_L(_ � -;�� /ri /�.� ,_`�t � .k.�. /uci NI I(� 13� ��a5���`�-.S`jOd <br /> � <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> ,`�,. ,,,�J ,rS y�s �1cc) 1zv ����o <br /> CONTRACTOR ����,��� ;�;�„ / /�,} ADDRESS CITY2IP PHONE <br /> /7��c1 /-'�'f/!!/� lr_!n� /L'E� SIc l) <br /> CONTR.UCENSE p ���5 <br /> //L''>iT63L 955�'C.� !',��/r�// /�'�� '%�,��d � y�S7 3%t�-. <br /> USE OF BUILDING HEAT SOURCF CONTRACT PR�CE OF WORK <br /> �ytµ{!� «,.�r I. 1 � C u S..i a �Electdc _Gas_O�her ��'��� � <br /> WORK DESCRIPT ON <br /> f� 6 � Cf< , � <br /> �. c: C1i` c � 1 �Y�. � bl..'rtlk r - �': c ��.S lt' r:�. �/ <� !:+ �lc< ric11 �[� S �7 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C-alr handling unils <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Walar healer <br /> Kitchen sink 8 disposal Gas lireplace <br /> Dishwasher Gas range <br /> Clothes washor Clothes dryor <br /> W�ler hrJalor Ranga hood <br /> I _ Sink (servicelbar/moplelc.) _ Exhausl(an <br /> Backllow prevenler Hea�pump <br /> Urinal Unit liealer <br /> Drinking Founlain 6oller <br /> Floor drain Refrigeralion <br /> GrPaso Irap Woodstove <br /> Rouf drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODF IS�105 <br /> I herc�by cerilily ihat I have mad and examined Ihis applicalion and hnow lhe same lo be lrue and correc�. All provisions ot laws and <br /> ordinaces goveming Ihis type ol work will be complied with whethor specifiod herein or noL The yran�ing ol a pertnit does nol presume <br /> to give authorily to violate or ca�cel the provision ol any other stato or local law regulating construclion or Ihe pedcrmance ol <br /> construclion. Thal I am authoriz by the uwner of this property to perlorm the work lor which epplication is made and I comply with Ihe <br /> Slate Co DFs . .7 R and 296.200 WAC. <br /> Signalur Ow r/C lra ulhorizod Agenl �� a e ^ <br />