Laserfiche WebLink
� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERFTT, WA 9820i <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org I <br /> APPLICATIONS ARE ACG'EPTED FROM B AM TO 4 PM <br /> SITE ADDRESS E"«�� W G pARCEL TAX I.D.# PERMIT# I <br /> -3 ��0 3���.a„��.� �,���, o�y��,o-, � o -i o o F3o���- <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION!i <br /> DESC. � � '7 �I I <br /> OWNER ADDRESS CITYIZIP PHONE <br /> �—ro� �c.n5c� ��ly S�'�1�-� V��--� �X\�.�l..a. V� `�l5-`�SC.<�6b`l <br /> TENANTNAME CONTACiFORPERMIT PHONE do�,-��b3�hl,B`l �G„I. <br /> !1� � 1.��"1�i..I �'�.� T!'c,—� �cnScJ E-MAILtfc—��.•.}C�J(.'�u}�'CA.(n. <br /> L NTRACT R A S 1T1'21P NE <br /> CONTR.LICENSE# N�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> „(C , � �Eleclnc _Gas_Other ,�I;� <br /> WORK DESCRIPTION <br /> ��,......� � � �%S�= <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM11 NO. TYPE OF FI%TURE OR ITEM <br /> Toilet FVC—air handling unils <br /> Bathlub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water healer <br /> Kilchen sink d�disposal _ Gas fireplace <br /> Dishwashcr Gas range <br /> Ciolhes washer Clolhes dryer <br /> Water heater Range hood <br /> Sink(serviceNudmop/etc.) _ Exhaust(an <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Orinking Fountain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease trap _ VYoodslove <br /> Roof drains Other <br /> Other _ — , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby cerilily thal I have read and examined this application and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether speci(ied herein or noL The granling ei a permit does nol presume <br /> to give aulhoriry to violate or cancel the provision o(any other state or local law regul::ting construction or the periormance of <br /> cunstruclion.That I am aulhorized by lhe owner of lhis property lo pedoim the work tor which application is made and I comply with the <br /> Slate Contractors Law 18.2712CW and 296.200 WAC. <br /> '1,y�� YJT'�,--. 1 D •'�-1•O 0 <br /> Signalure of OwnedConlraclor/Aulhorized�genl Date �/v <br /> �__ _ —_- ( <br />