Laserfiche WebLink
; ' � ---- <br /> . <br /> j 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 /> i <br /> I APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I <br /> SITE ADDRE� PARCEL TAX I.D.# PERMIT# <br /> � Q S o�a S' -oc� <br /> LEGAL lOT NO. BL CK TRAC�� <br /> DESC. <br /> O ER ADDRESS CITYIZIP PHONE <br /> � ,� IJCt.0 �28 I r �(1 0 , k'vt�' y%5� -�_ <br /> �IEflANT NAME CON ACT FO�PERMIT PHONE <br /> CONTRACTOR � r� ��� A DRES /7(f/IA flj��,✓�n.�+ /�TYlZ�P r�,,,. _PJj_�N�_ �r�f1� <br /> / !�'� �7w(IYJIJ/lK1X��( L��C,h(;7j b c� <br /> CONTR.LICENSE# ->/� <br /> �r ru �Z7C n� ��f'�-5- 7`1� � �� � <br /> USE OF BUILDING HEAT SOURCE �CONTRACT PRICE OF WORK <br /> , - �Electric _Gas_Olher ��v <br /> WORK DESCRIPTION�I'��L- 1/ �a\ c�-}C 6 3O f fC /7J! �,� �5 � /j f <br /> �__�� ���� J n.�.� <br /> f►�Ii ��i�ua.l (�-tk�rs mo,�,.j-��a� en�-l��-nA.! �rri� r��cerua� , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYP[OF FIXTUR[OR ITEM <br /> Toilet A/C-air handling units <br /> Balhtub Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kilchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Water healer Range hood " <br /> Sink(service/badmop/elc.) Exhausl fan <br /> Backflow preventer Heal pump <br /> Urinal Unil heater <br /> Drinking Fountain 6oiler <br /> Floor drain Refrigeralion <br /> Grease trap _ Woodslove <br /> Roof drains Other_ _ <br /> Olber <br /> I — <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby�erilily Ihal I have read and examined this application and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces goveming Ihis rype ot work will be complied with whether specified herein�r nol Tho granting of a permit does not presume <br /> to give a�thonty lo vio�ale or cancel the provision of any olher slate or local law regulating construction or the performance of . <br /> construclipfi. h am auth rized by Ihe owner of this prope y lo peAorm lhe work for which application is made and 1 wmply with the <br /> Slate C c or ; w_18.2 RCW and 29G.200 WAC. � <br /> Signat re on c /Authonzed Agent Dato / <br /> /� <br />