Laserfiche WebLink
- -- - -- ------( -� - <br /> � ----__...- <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.N PERMIT M <br /> /�f-p /b.4 r c72 Si3ec�t�T 't.o�0'7 -0 I� <br /> L[GAL LOTNO. — BLOCK TRACT <br /> fiCSC <br /> OWNEft A�ORFSS CITV121P PHONE <br /> AJA i2 ��v r�,uPe �s��.S <br /> 7ENANT NAME CONTACi FOR PERMIT PHONE <br /> CONTRACTOR '�/���Si�� nV�m�� ADDRESS CITY/ZIP PMONE <br /> CON7R LICENSEN � z�3�U ��-`�nf /���� /�/I L-/a.7(�/7,� jb�� " �f05 "�vE 1. <br /> �'cg�Nl�A2�Lcy .,.e' <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK � <br /> __ S �� I _Eiectnc _Gas_Other .3 �n��� ��� <br /> i <br /> WORK DESCRIPTION <br /> /i✓ $iAL4 G �i1L S/�/l��K�L')Z �r� Nc-�7v SF� <br /> PLUMBING MECHANICAL <br /> HO. i TYPE OF FI%TURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> _.__.j—______--_ <br /> ___'� io��el A%C -av han0ling uni�5 <br /> ____ Batntub Forcetl arc systems <br /> _ Lavatory�wash bas;n) Gas O�D�ng <br /> ._ Snower � Water heate� <br /> _..._ Kdchen 5�nk R tl�s�osal Gas hreplace <br /> ___ ��shwasher Gas ranqe <br /> _.__ GUthes wa5he� C101hes tlrye� <br /> __ Launary tray Range n000 <br /> ._ S�nk (service'barrmopietc) E.haus�lan <br /> .__ Backllow preventer Heat pump <br /> __ Urinal Unit hEatei <br /> ___ Orinking Fountain Boiler <br /> ___ Floor tl!a�n ReingeraUon <br /> __ Grease Vap Woodstove <br /> __ RoJ�tlr3m5 pther <br /> Glher — - <br /> _— �(Q SI�RiiJCLL'n /ICiF2�S <br /> i <br /> CITY OF EVERETT LOCAL SAlES TA%COOE IS 7105 <br /> � '�ere0y ce��hf y Inat I hav2 reatl ana eaaminetl Ih�s apphCaOon antl FnOw Itie 5ame Io be Irue antl CorreCt Ali Di0vi5ion5 0l Iaws an� <br /> ,�;�races go��ern�ng In�s ryDe ql work wiu be ccmpned wrtn wnetner speo6etl nere�n or not The granting ot a Oermit tloes not presume <br /> ',:��ve authon�y!o nolaie Oi GanCel IhC prpvi5i0n 0�any Other SI3Ie Gr IOCaI Idw r99ulalmg ConSINChon Or �hB p2rtOrmdnCE Jf <br /> �:snsrru..uon That I am authonzetl by the owner of Ihis Droperty to perform Ihe work for which apphcation is made and I compiy v,,tn 1ne <br /> "-+:o C�nt�actois La�, 1 ..� CW and 296 200 WAC <br /> _ aiwe of �vneuConlractonAuthonzetl�gent � Dal�'� <br /> ._ ._ _-- ------- ----------------------------- � <br /> �/ <br />