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 />� C7(c,0C1, - C�� 1 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8� CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADD ESS <br />r�Z I " � L,� <br />LEGAL LOT NO. <br />DESC. /��_ <br />PARCEL TAX I.D. # <br />�� ti� . F �;Z= <br />,. <br />BLOCK TRACT <br />� � ��� <br />ADDRESS <br />PERMIT # <br />.-1 i'���;'L�'�t� � �i'���`�'�l'� ��,��=-t 5 2 "� �'�' �' 1�� (���� ��k'��;'� <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />N`-�- ,�!�j �'' � � ��7��'� � `� i k' C���:"���(L �f� �>; ��3�:; ��- � - <br />CONTRACTOR �i �� �y�� ��� I�---7�� �' ADDRESS CITY/ZIP PHONE <br />(6 {�� �i� <br />�� ( � ��"L'�l C` j �Q�,S l,i.v-� Ll �L'�Ll�i�-��� �L�'',� , c��'L ��c: �� <br />CONTR. LICENSE # � ,�,� � 4 � <br />�7 � j� �' ��'� `� � -� .�. <br />USE OF BUILDING I HEAT SOURCE � CONTRACT PRICE OF WORK <br />����j,J��� �����yf j���� Electric _ Gas _ Other r�� ���� <br />.,,� 6 <br />WORK DESCRIPTION <br />���� � <br />, <br />� t�l ��i �-�t� <br />NO. <br />'l2 �`�,:� 6�L'9` f"��-, ���_ �� t`1�1C�' /��' Sr���kr <br />LUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8� 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 />NO. <br />MECHANICAL <br />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 />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 specifed 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 Cont[actors.l.a�;8.27 RCW and 296.200 WAC. <br />�� -1� '��E <br />Date Y <br />2 <br />