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 � / PARCEL TAX I.D.ft PERMIT N <br /> ��(oZ� �v �/tOl G053�90600 Z gvtooh—o3� <br /> LEGAL LOTNO. BLOCK TR C�o�iCa C ,��� <br /> DESC. L✓lp[i U <br /> OWNER ADDRESS CITY2IP PHONE �.ZS <br /> �it���e C�up22� l((�ZS��j�orff?d � � �� �1v�`f 33S q�Z9 <br /> TENANT NAME CONTACT POR PERMIT PHONE <br /> �'ov���be, ��a/-�l ��e��l�aava� 425� 77�� 47o i <br /> CONTRAC— 70R l LG ADORESS CITVIZIP PNONE 4 ZS <br /> �1/1.4N /����� L /,� R2 <br /> CON7R.LICENSE• 1'�f/� ,��/�°�h�,vG . ,Ul�i�S�,��� R�Zlo Z71J � <br /> �ei/nuv/ O/_�.AAM _ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE Oi WORK � <br /> C��VG� _Electric _Gas_Other I � ���� �� <br /> WORK DESCRIPTION <br /> ,�'�� �i ��e� �G � <br /> , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM I <br /> Toilet _ A/C—air handling units - <br /> Bathtub _ Porced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower � Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher � Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> I Backflow preventer _ Heat pump <br /> � Urinal Unit heater <br /> I Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains . Other <br /> Other <br /> I CITY OF EVERETT LOCAL SAlE3 TAII CORE IS�105 <br /> II 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 /> I, 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 ro wolate or cancel the provision of any other state or local law regulating constructio�or tne perfortnance of <br /> �i construction. That I am authorized by the owner of this property to perform the work for which application is made and I comoly with the <br /> State Contr or Law ��296200 WAC. � <br /> � 5�� � <br /> i Slgn�e o Ow�Contracror/Authonzed Agent Date <br /> � 'n <br /> I _ <br />