Laserfiche WebLink
�-S -OCo <br /> ------------ ----------- ---- — — <br /> P�RMIT APPLICATIdN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAF; STREET, EVERETT, WA 98201 <br /> 425-257-8810-•FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> SI�E ADDRESS � /� 7ARCEL TAX I.D.N PERMIT A z <br /> � W �ihn 1`tY I�.vo� ��/' � . G�0 - U / <br /> LEGAL LOT NO. BLOCK TRAC� / ^ � �y <br /> DESC. �'� " �� �'JN+Pn. S <br /> �_� e�-nf <br /> OWNER ADORESS CITY2IP PHONE <br /> Zr+e.�,e �rp. 17�12 r��l�<l� �it/o�./1/� �o���{ Y1/� �`�-' S�.}A9-��c,�i-d <br /> TENl1�� NAME CONTACT FOR PER IT PHONE <br /> � l.�,o,s,� 9-2ti 77v - ).2�= <br /> CONTRACTOR ADDR CIiYIZIP PHON6 <br /> -3 �o a�%1^� �i C. 31��4 '}�Dr.s�, �o�.�./?iv� 9sa�� ��-1 s�,2R G-6 n�/ <br /> CO�.LICENS M U <br /> USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �����„���_ I _Eleciric __�as_Olher �-� ��Q � <br /> WORK DESCRIPTION / /�/ /J <br /> � (� f� _>(�.l�ic_s uvCT nr.FAi �le..�' '-'p�n. f�ld� - <br /> PJ oJ �trm�u6' a+• � r <br /> Re-cb��v� ; 2 �p� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%1 URE OR ITEM NO. TYPE OF FU(TURE OR ITEM <br /> Toilel _ AIC-air handling units <br /> Bathtub _ Forxd air systems <br /> _ Levatory(wash basin) _ Gas piping <br /> Shower _ Water hea�er <br /> Kitchen sink 8 disposal _ Gas lireplace <br /> Dishwesher _ Gasrange <br /> Clothes washer _ Cbthes dryer <br /> Laundry lrey _ Range hood <br /> Sink(service/bar/mopietc.) _ Exhaust fan <br /> Backtlow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fa�nlain _ Boiler <br /> Floor drain _ Refrigeration <br /> Grease trap _ Woodstove <br /> Rooi drams _ Other <br /> Other — — <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS J106 <br /> I hereby ceritdy lhat I have read and ex�ined Ihis applicalan end know the same to be true and corted. All provisions o(laws end <br /> ordinaces goveming Ihis rype ot worlc ill be complied with whether specified herein ar not.The granting of e pertnit does no�presume <br /> to give euthairy to violate or cancel t e�rovision o(any other state a locel law regulating construction or the peAormance ol <br /> construdion. Thal I em aulhorized ll owner of Ihis property lo peAortn the work 1or which application is made and I comply with the <br /> State Contradors Law 18.27 RCW pd 296200 WAC. <br /> <`�-�-��_� _� ' �9 0 � <br /> SignoWre o Owned� oNradodAuthonzed gent Da <br />