Laserfiche WebLink
� P�RMIT APPLICATI�N ' '�J ��''" <br /> CITY OF EVERETT PERMIT SERVICES �'�r �`''��"`�`"" <br /> 3200 CEDAR STREET, EVERETT, WA 98201 Sw�'� <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> y F,� ,� _ <br /> LEGAL LOT N(� BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRFSS CIN/ZIP PHONE <br /> �?l�= �<L}�E,( ll�� �i�G�� � L�Ni'� <br /> TENANT NAME CONTAC FOR PERMIT PH�N€��C '`�,�,,!/� <br /> �� �� �� �� � �' <br /> � / �+� E-MAIL Cu' � �Ij�r <br /> ..�rr�an n r Fa <br /> CONT A TOR ADD INIZIP NE <br /> ,.�..�/� �p �rl ��.3.�r9�s� �,f�,:yS�aa�i yas--�s-1'6s�� <br /> /��"ii�f c �' <br /> CONTR. ICENSE# ' <br /> ,,�i��',e�scr>:s7�c' <br /> USE OF BU,�ILDING HEAT SOURCE CONTRACT PR{CE OF WORK <br /> {` „[� _Electric _Gas_Other <br /> ;zit. <br /> WO�K DESCR�T ON K�S. /� �.J ` .._/tf ��,�� <br /> � F �� �� � �'� ��� <br /> ��� E� � <br /> PLUMBING MECHANICAL <br /> ryp. NPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> Toilet. : , . . _ FVC–air handling units•� ' <br /> Bathtuu �� ��!� � Forced air systems '� <br /> Lavatory(wash basin) � \I � _ Gas piping <br /> � _ Shower !i _ Waterheater <br /> _ Kitchen sink&disposal ( / 1 �� _ Gas tireplace <br /> Dishwasher /1 /� _ Gas range <br /> � _ Clothes washer II �,�� _ Cbthes drye� <br /> Water heater � _ Range hood <br /> Sink(service/bar/mopletc.) � _ Ezhaust fan <br /> = Backflow preventer �o� _ Heat pump <br /> Urinal ,(� Unit heater <br /> _ Drinkiny Fountain �O'�� Boiler <br /> _ Floor drain ���� Refrigeretion <br /> = Grease trap _ (� � Woodstove / • �/ <br /> _�Gqi�—,[/A'S <br /> Roof drains � I�v� �f� Other / <br /> Other — <br /> — , <br /> � CITY OF EVERETT LOCAI 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. AII prcvisions of la�vs and <br /> I ordinaces governing this type of work will be complied with whether specified herein or noL The grenting of a permit does not presume <br /> to give a ority co violate or cancel the pmvision of any other state or!ocal law regulating construction or the performance of <br /> censtru i . i ha am authorized by the owner of this property to perferm lhe work for which application is made and I comply with the <br /> i State racto aw 1 7 RCW and 296.200 WAC. <br /> ' L,� �"-/�-�7 . <br /> Sign ur of OwnedContraclor/Authorized Agent Date <br /> 1� <br /> L_. _ . ___ _ . . —_—_. <br />