Laserfiche WebLink
PERMIT APPLICATI(JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—Fr.X 425-257-8857—www.everettwa.org <br /> APPLI(:ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ( � 5—O � <br /> SITE AODRESS PARCEL TA%I.D.M PERMR M / <br /> ���,o� c��a i� � 4 �tiz,�-i n1 ��'i `7' <br /> LEGAL LOTNO. BLOCN TRACT <br /> �ESC <br /> OWNER ADDRE55 CITV/I.IP PHONE <br /> _�rarrlt�, ��.��9 m�� \ v� I�i�n.r b 1 O'� C r rU.� �{i.� [V�. ��rt Z03 (`iZS��3�1� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE , I ,` <br /> CONTRACTOR (��.1.�,f"�'�.� ADDRESS CITV2IP PHONE <br /> i �v SIt�H•. �� .�n <br /> � CONTR.UCENSE M r. <br /> rlr��5?�c' 11 �1E� 1 L—T" �µGi(, ,.��� , 1�{ uu�• Y71cr�c.,l�i 19{,b 143 i: � 5" <br /> USE OF BUILDING HEAT SOURCE CON RACT PRICE OF WORK <br /> I _[lectric ✓Gas_Othar � �`(��, �i I <br /> J� <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. T."�E OF FIXTURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> Toilot A/C—eir handling units <br /> I Dathtub Forced air systems <br /> i _ Lavatory(wash baen) _ Gas piping <br /> Shower tar Mater <br /> IIGtchen sink 6 dis{�sal _ Oas fi�eplace <br /> 'I _ D�shwasher _ Gas range <br /> i = Clotheswdsher = CloMeadryer <br /> Laundry tray Range haod <br /> Sink(eemcelberlmop/etc� E*heust fan <br /> � Beckflow preventer _ Heal pump <br /> � Unnal Unit heater <br /> �� _ Dnnkmg Fountain �oiler <br /> �I Floor tlroin _ Reingera0on I <br /> G�easa hap _ Nbodstove �, <br /> I� Roof dreins Other _ �, <br /> i _ Other = <br /> � CITY OF EVERETT LOCAL SRLES TAX COD[IS N06 <br /> ! I hereby caritdy that I hava read and examinad this epp�icaUon and know the same lo be Wa end corted. All proviaions ol lews and <br /> '� ordinaces goveming this type of v.ork vnll 6e wmplied witli whether spedfied herein or not.The grantlng of a partnit does not presuma <br /> � ro give authonty fo violate or cancel the provleon ol eny other shato or local law reguletlnp wns6uction or Me peRormance of <br /> consiruction. Thal I em authorized hy the owner ol ihis property to pedorm tlie work for which applicatlon ia made and I comply with the <br /> i Stata antractors Lew iB 27 RCW and 2�JG 200 WAC <br /> li ' `^ � _ <br /> i Si net r o Own I ontrachxlAuthonze gent ale <br />