Laserfiche WebLink
/ <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 <br />SITE ADDRESS ��3 � TT� ,�L—vE � PARCEL TAX I.D. # <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP <br />�j�4�,rZ �=�N�-rzP2cscS <br />TENANT NAME � CONTACT FOR PERMIT <br />PERMIT # <br />PHONE <br />CONTRACTOR ��NSvti �L�/���� ADDRESS CITY/ZIP PHONE <br />�-933 v �z�.Z� ..� lo� _ <br />CONTR. LICENSE # � �v� ic./ � ��4 ��� � �f U 3"7 S��o Z <br />/Zo g�iJ P �- �--�'L.c 3 <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />sr=,e <br />Electric Gas Other �.3 Z CrU <br />WORK DESCRIPTION <br />/ti s�1�--(.-� ��� E SP,e. �r�/!C c. t��,s �°L�2. � r-�.4 / b t7 �.�. ,�/ �.�t, <br />S F� <br />PLUMBING <br />NO. 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 />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />MECHANICAL <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 />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />� s ,e.,.���s <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I 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 not. 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 Contractors Law 18.27,ReW and 296.200 WAC. <br />Sign <br />nt <br />