Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE1, EVERETT, WA 98201 <br />425-257-8810 -FAX 425-257-8857 - vnvv✓.evereltwa.erd <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/b -9 —O / <br />PARCEL TAX I.D. N <br />PERMIT N <br />SITE ADDRESS <br />50A Tit <br />�. <br />LEGAL LOT NO. <br />BLOCK TRACT OR SUBDIVISION ff <br />nESC. <br />`5F4I'4 Tt✓ Z$tPC-,EOSQT-ISB <br />ADDRESS CITYrZIP <br />PHONE <br />OWNER <br />f?p. /316 x 4.S619 <br />�m r/e to <br />s+'�s6t1LL COvusMe <br />PHONE ?-3QS z /Z � <br />TENANTNAME <br />I CONTACT FOR ERMIT <br />CT6- AUVII <br />ou �lEc{�cSt�N <br />CONTR. LICENSEp <br />USE OF BUILDING <br />HEATSOURCE <br />Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />TNsYIa(�C1) tJo/J�IIIuMWAiE S/� WI►Il S[sy►JCz��~+'�� orJ i1EE W--stSzc& oC't3wlOnfy <br />140. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backllow prevonter <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other __ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heal pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />hereby cerllify that I have rend and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this typo of work will be complied with whether specified herein or not. The granting of a permit (foes not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating constru6Von or the performance of <br />construction. That I am authorized by 1110 owner of this property to perform the work lot which application is made and I comply with the <br />Slats Coand 296.200 WAC. <br />9 �GZ <br />gn�aturo o� I O !Contractor genttn (2 <br />