Laserfiche WebLink
III <br />PERMIT 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 G ,1 6r0/ <br />SITE ADDRESS 0 PARCEL TAX I.D. # PERMIT # <br />200o r,A Avti 0 - <br />LEGA LOT NO. BLOCK TRACT OR SUBDMSION N <br />DESC. <br />OWNER ADDRESS CITYIZIP PHONE <br />TENANT NAMEE/� CONTACT FOR PERMIT PHONE <br />(' _c, f.b EMAIL <br />...J <br />COANT7R. J7wc�� <br />CONTR. LICENSE N <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other <br />I <br />WORK DESCRIPTION ) Ct C-h j <br />i <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />— <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />_ <br />Dishwasher <br />Gas range <br />Clothes dryer <br />_ <br />Clothes washer <br />Range hood <br />_ <br />Water heater <br />Sink(service/bar/map/etc.) <br />—Exhaust <br />fan <br />_ <br />_ <br />Backflow preventer <br />— <br />Heal pump <br />Unit heater <br />_ <br />Urinal <br />Drinking Fountain <br />— <br />— <br />Boiler <br />_ <br />Floor drain <br />— <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />_ <br />Roof drains <br />—Other <br />_ <br />Other <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and <br />herein or not. The granting of a permit does not presume <br />ordinates governing this type of work will be complied with whether specified <br />of any other stale or local law regulating construction or the performance of <br />to give authority tiolalecel the provision <br />auW <br />construction. Thaam aud by the owner of this property to perform the work for which application is made and I comply with the <br />State d 29620 WAC <br />/ <br />b �J Q <br />Signature of Owner/uthorized Agent Date <br />