Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAH STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �(v���}- -Up t <br /> SRE ADDRESS � PARC':�TAX I.D.N PERMIT N <br /> 37�D �- � Q �lo c%�y3�3�2Sflae�a i <br /> LEGA LOT NO. B CK TAACT OR SUBDIVISION M <br /> DESC. <br /> OWNER ADDRESS CtTYTP Pf10NE <br /> �_,���' Crf�ua2 y �e,�'CrGI�C .Z7�7 �'9�kQ���Q�-fi�� ���tt' <br /> TENANTNAME �<�-,i,��� ��� ����� I CONNTACTFORPERMIT PHON� 'Xj�j �-�/J��Zi <br /> f7�����II�� ��iv/ /?J�iL7/� ���'L'J E�AAIL <br /> ���iLec' �QN �.r;noj�� 3Slo s: r(�ITr Sfi .�r. y°1!$ 5`,ZS-b'6y-�s'y <br /> CONTR.LICENSE# p� � STR.�jVDD�,�SL��x�J. ���.-D�f <br /> I f� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � _EledriC Gas_Olher � ��-le�v '�-J�'� �''� <br /> Mk p��'�� ���:t: �. <br /> woa �)uCr�� n ��-+i n o� f'o r- /t/�w 9'��f sq�-Fr. /Ze5-f'v-��'" i'�� � <br /> � a- GqS P . <br /> PLUMBING luIECHANICAL <br /> NO. TYPE OF Fl%TURE OR�TEM NO. TYPE OF FIXNRE OR fTEM <br /> J_ Toile� _ AJC-airhandlingunits <br /> BathWb Forced air systoms <br /> _(_ Lavatory(wash basin) �_ Gas piping <br /> Shower _ Water heater <br /> _,�f Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clolhes dryer <br /> 1 Water heater Range hood <br /> � Sink(service/badmop/etc.) _ Exhaust fan <br /> � BackllowpreveMer _ Heatpump <br /> Urinal Unit healer <br /> Drinking Fountain �_ Boiler <br /> Floordrain _ Refngeration <br /> � Grease lrap Woodstove <br /> Roof drain; � Other e � r� <br /> _ otner —L _��-_�_ll__{'�no 'P <br /> ll � <br /> Clri GF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify ihat I have read and examined this applicaGon and know the same lo be true and correct. All provisions o!laws and <br /> ordinaces goveming this typo of work will be complied with whother specified herein or not.The granting of a permit dces not presume <br /> to give authoriry to violate or cancel the provision of any olher stale or local taw regulaling construction or the pertormance of <br /> construclion.That I am authorized by the owner ot this property to pedorm the work for which application is made ard I comply with the <br />� State Co�irado�rs law 1827 RCW and 296.200 WAC. <br /> /I! <'���y�—�- �� ��• O� <br /> Signature of OW�nar/ContractodAuthonzed Agent Date <br />