Laserfiche WebLink
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 <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHON <br />1A1,*17Z'6-1 Z"-� LZ-e- lg'�2y Ale <br />TENANT NAME <br />CONTACT FORPERMIT <br />/PHONE ��rr <br />I 6919 V/n <br />CONTRACTOR f f S1 ADDRESS II CITYTZIP PHONE <br />j oYl ,�>°6LCli �Vio act/its✓1%f �f�S `��OJ ���� <br />CONTR. LICENSE # ae ��/V <br />L C <br />USE OF BUILDING <br />HEATSOURCE <br />CONTRACT PRICE OF WORK <br />! ep `�Z";/'_Electric <br />Gas _Other <br />WORK DESCRIPTION <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 />i <br />Bathtub <br />Lavatory (wash basin) <br />J <br />Forced air systems <br />Gas piping <br />Shower <br />Water heater <br />I <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan. <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or riot. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Co t ac • r ww 18.27 RCW and 2 WAC. <br />/ l <br />Signature of Owner/Contractor/Authorized Agent Date <br />