Laserfiche WebLink
P�r2MIT 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 - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE`DDZ� B f o qd w�{ Y 3 I 9��1�3-��Y - a oo ( PERMI�II � <br /> a �r <br /> LEGA LOT NO. BLO K TRACT <br /> DESC. <br /> OWNEP. ADDRESS CITY2IP PHONE <br /> � ef��tll Pr�v y717 At,vvc� /�.�G S .S���i .�— ZoL- 7�3 ' L� 2� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �F�frll Ui..� I S-fc�a /�Lo�til, Y� 77� 'Q83�3'- <br /> CONTRACTOR �{Grrr /1/Co.vto A�DR!SS CITY2IP PNONE <br /> 7;(eo /la..I,se... n� �fis- 77C-�r $35— <br /> CONTR.LICENSES � G/�rNCo7�c�^ . �✓trt4-�J (y�- r7g205 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S�o�L _Eiectric _Gas_Other � Z.y 97` �� <br /> WORKDESCRIPTION ��5��[G �/� SiS�v ci3Sjtic�{- � CZ ) Me55/Jf� Cr,�(z�c�, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory (wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishw2sher Gas range <br /> Clolhes washer Ciothes dryer <br /> Laundry trey _ Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Foun4,in _ Bailer <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> � <br /> � CITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br /> II hereby centify that I have read and examined lhis application and know the same to be true and correct, All provisions of laws and <br /> � ordinaces goveming this rype of work will be complied with whether specified herein or not.The granttng of a permit does not presume <br /> , to give authonty to violate or cancel the provision of any other state or local law regulating construcUon or the performance of <br /> construction.That I am a lhorize the ner of this property to pertorm the work for which application is made and I comply with the <br /> � Slate Contractors La .27 .200 WAC. <br /> I <br /> Signatu� OwnenContractorlAuthonzed Agent Date �L <br />