Laserfiche WebLink
P�RMIT AP�LICATIUN <br /> CITY OF EVERE'�T PERMIT SERVlCES <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 <br /> SITE ADDRESS PARCEL TAX I.D.8 PERMIT# <br /> 3��z,�l����D- , ��,—,u�� z�i -� r> (�, a-r�o5 � <br /> LEGA LOTNO. BLOCK TRACT i <br /> DESC.J I <br /> OWN`E�R AODRE55 CITYIZIP PHONE , <br /> N/��� � - 27/7 ,�'e�.k✓S��u.��a �cJT. � � �%�'/ �/"1� 2i7 - 2�/o I <br /> TENANT NAME CON TACT FOR PER TJhLK � �'�!, � PHONE I <br /> /� // ` ' CcCVL�-73�-0923 / <br /> 7"A-tiv� G�i��ll ��f?�> I✓�-�'k.1 5�2s-77G ��'d'3� <br /> CONTRACTOR ADDRESS CITYlZIP PHONE <br /> �'� � FroP OiJ£2 <br /> CONTR.IiCENSE# ����,2,�hfCQ7�C. M �" <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Electric _Gas_Olher 'T � �� �.� <br /> WORK DESCRIPTION <br /> ��1�C.t ' � �j'� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet NC—air handling unils <br /> Bathfub Forced air syslems <br /> Lavalory(wash basin) Gas piping <br /> Shower W aler heater <br /> Kitchen sink&disposal Gas firepiace <br /> Dish�vasher Gas range <br /> Clothes washer Clolhe=dryer <br /> Waler healer Range hood <br /> Sink(serviceNar/mop/etc.) Exhaust fan <br /> Backllow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roo(drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriti(y that I have read and examined lhi;application and know lhe=ame to be true and correcL All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whelher speci(ied herein or not.The granting of a permit does nol presume <br /> to give authorily lo violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construclion. That�am authorized by the owner of this property lo perform the work for which applicalion is made and I comply with the <br /> St tractors Law and Z96.200 WAC. <br /> / r <br /> �� i,t�� �e.��i— �Z //�L- <br /> Sign ure of Owner ontraclor/Authonz�d Agent Dale �/' <br /> �' <br />