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 />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT# <br />LEGAL LOT N0. <br />BLOCK <br />TRACTOR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS CITYI2IP PHONE <br />-Z-SaaC. G.eL f3a�yA -13evetIy l3/rti1 �iier,e& �8zo3 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />c� <br />E-MAIL <br />CONTRACrOR d /( f 1O 1- Ulur 6.LIq �%Oy e;Z 7 S-3,c'.8 3�%lfcr ct <br />, �� 11 <br />CONTR. LICENS�#LL 132 0p����UP w <br />�RPP L(3 C, CJ 7 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric Gas. Other <br />700 • <br />I <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />N0. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ <br />Bathtub <br />_Forced <br />air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink &disposal <br />(� <br />Gas fireplace <br />Dishwasher <br />_Gas <br />range <br />_ <br />Clothes washer <br />_Clothes <br />dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />_ <br />Sink (service/bar/mop/etc.) <br />_Exhaust <br />fan <br />_ <br />Dackllow prevonter <br />_Heal <br />pump <br />Urinal <br />Unit healer <br />_ <br />_ <br />Drinking Fountain <br />_Boiler <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstovo <br />Roof drains <br />_Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates 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 to violate or cancel the provision of any other slate or local 13w 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 tors Law td 7 R('.�V and 296.200 WAG. <br />Signature of Owner/Contractor/Authorized Agent Dale <br />