Laserfiche WebLink
PE�MIT APPLICATIOIV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-25%-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> SITE ADDRESS L VP re PARCEL TAX I.D.k PERMIT N <br /> '� � '� 'I;:c.�'s. r,�'�,� WS'3 /G ' 0 �J —n� <br /> IEGHL LOT NO. BLOCK TRAC70R SUBDIVISION N <br /> DESC. Q������ � j <br /> OWNER ADORESS C�TY21P PHONE <br /> (Y� �ke L.'�`i e� I , ��` �I 3 i3��' V�l i-r I f�. ;n,�y �3��e. I! ��� l 3 a3 s� 1 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> I <br /> J'P. <br /> CUNTR.LICENSE p <br /> USE OF BUILDING HEAT SOURCE CUNTRACT PRICE OF WORK <br /> _ 2D nt-C�' �loclric _Gas_Olher <br /> —1_ ' <br /> WORKDESCRIPTION ��N /�J`'' ►7G�r � N��R� �7t t1�Y� �� M�• f��c.Y� rl , <br /> i <br /> � r� � `�r��.��u�l �h�.�;��ti 1 <br /> PLUMBING MECHANICAL <br /> NO. � TYPE OF FIXTURE OR ITf M NO. TYPE OF FI%TURE OR ITEM <br /> I _ Tuil�.l _C ArC-air handling unils <br /> Bathlub O Forced air syslems <br /> � Lavalory(wash basin) C` Gas piping <br /> �f__ Shower � Wator healer <br /> (� Kilchon sinA S disposal y'; Gas lireplace <br /> _L Dishw.shcr _y'� Gas renge <br /> �_ Gothes washcr �_ Clothes dryor <br /> Waler healer Ran�e hood <br /> Sink(scrviculbar/mop/o1cJ �_ Exhausl lan <br /> � 6ackflow preventer Heal pump <br /> � Urinal � UnY healer <br /> _� Drinhinq Founlain Boiler <br /> ��. Flooi drain Relrigerelion <br /> �� Greaso lrap WooAstovo <br /> '-' Rool drains Olher <br /> V Olhor <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby cerilify Ihat I have road and examined Ihis application and know Ihe same lo be true and correct. All provisions oi laws and <br /> ordinaces qoveming Ihis lypo ol work will bo compliod wilh whether speciliad herein or noL The granling ol a permit does nol presume <br /> Ito c�ive authonty to violate or cancel lho provision ot any othor slale or local law reyulatin�construction or lhe peAormance of <br /> construction. Thal I am authorized by tho owner of thia property to pedorm the work for which applicalion is made and I comply with the <br /> Slale Contraclors Law 18.27 RCW and 29G.200 WAC. , <br /> � � i�`''1 <br /> 1'�l�;. :=: � � , a� <br /> Siy�iature of Owner on�rador/Aulhorized Ayent Da�o <br />