Laserfiche WebLink
�ERMIT APPLICAT�iV <br /> CITY OF EVERETT PERMIT SERVICES � S -0� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �— <br /> 425-257-8810— FAX 425-257-3857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � ��V� � It <br /> SITE ADDRESS PARCeI_TAX I.D.R PERMIT# <br /> � � d� l� �,c�u,z' _�6as-oo ? <br /> LEGA LOTNO. BLOCK TRACT � <br /> DESC. <br /> OWNER ADORE55 CINIZIP PHONE <br /> l� C� ,� <br /> TENANiNAME I CONTACTFOR PERMIT PHONE <br /> CONTRACTOR -� • AUDRESS CITY2IP PHONE <br /> � ��MJU^-� �.-� � {-�-� r �i �. �r'o..�� <br /> CONTR.LICENSE N �' <br /> �� L��.. ,L � �l 1-C`� � f+-� iC.- <br /> �E�__ <br /> USE OF BUILDING � HEAT SOUR�/ CONTRACT PRICE OF WORK <br /> n � O� <br /> �/��y �"Cc`' �'— _Ei�clric as_Olher �,(�p� <br /> WORK DESCRIPT�ON <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Balhtub Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower W aler heater <br /> Kilchen sink&disposal Gas 6replace <br /> Dishwasher Gasra�ge <br /> Clothes washer Clolhes dryer <br /> Water healer _ Renge hood <br /> � Sink(service/badmou�elc.) _ Exhausl fan <br /> BackOow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain _ Boi�er <br /> Floor drain Retrigeralion <br /> Grease trap Woodslove <br /> Roo(drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> I hereby cerilify that I have read and examined this application and know the same to be We and correcL All provisions o(laws and <br /> ordinaces c�overning this type of work will be complied with whether speci0�d herein or nol.The granling oi a permil does nol presume <br /> lo giva authont�lo vio�ale or cancel the provision of any olher stale ct local law regulating construction or lhe performance of <br /> construclion�Thel I am aNhori d by tho owr�er of lyis property lo pedorm the work tor which application is made and I comply with lhe <br /> Slate Cor,�rbU�rs Law 1 .27 �W and 296.20D WAC. <br /> / ��� <br /> �r��;�> ��?� 5�-1_�-� <br /> Signa re of Uwner/ 0 6cTodAuthonze genl ate <br /> v <br />