Laserfiche WebLink
PtRMIT APPLICATIUN <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3� � <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT# <br /> 6y/y �� R� adfo� -�- a36-ao a �-o� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> nesc. 3� <br /> OWNER ADDRESS CITYIZIP PHONE <br /> �AvtD uwN�57an� 6'//y G40� R�D fdElt�rt� Mzy-35S- 3�f69 <br /> TENANTNAME CONTACTFORPERMIT PH���-� �O <br /> B�Nr WR�� E-MAIL <br /> w�4uGE2 Con�STT��nanJ .1,2/ Sfi4TE AVE. 57�. 6 man.ysvicc� 3Go-f���ro <br /> CONTR.LICENSEM u�AShF 9BoZ7� <br /> WA�KEC��E' //.Z.Ko2 <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��- eo <br /> 5 F R �[lectric Gas Othcr oti��OQ� � <br /> WORK DESCRIPTION <br /> R�Pc�eE -rtf�� F�c�SnN6 sF2 wr-H� A� Nu� 5�2 m�Nuf�cxtt/�.O <br /> NoME (v� X a v <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM r10. TYPE OF FI%TURE OR ITEM <br /> Toilcl A/C-air handling units <br /> Balhlub Forcod air syslems <br /> Lavatory(wash basin) Gas piping <br /> Showor Water hoater <br /> Kilchen sink 8 disposal Gas lireplaco <br /> Dishwasher Gas rango <br /> Clolhes washer Clothes dryor <br /> Water heater Rango hood <br /> Sink(service/barhnuplolc.) Exhaust tan <br /> BackOow prevenlor Heat pump <br /> Urinal Unil healer <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Groaso trap Woodstove <br /> Roof drains Other <br /> 3 Olhcr�:���cr • ��G.,k'c <br /> — --LS�:�'�� 1��� _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I heroby corilify Ihat I have read and ozamined Ihis applicalion and know the samo to be irue and corcecl. All provisions of laws and <br /> ordinaces governinc� this type of work will bo complied wlth whelher spocilieA herein or nol.The g�aNing ol a permit does not presume <br /> lo give authority�o violale or cancel Iho provision of any olher sla�e or local law regulaling construclion or the peAormance of <br /> conslruction. Thal�am authorized by the uwner ol this proporty to peAorm the work tor which applicalion is made and I comply with Ihe <br /> Stalo Contraclors Law 1D.27 RCW and 296.200 WAC. <br /> .i�{ _...Q"F�[..��s— ��02��� <br /> Signature ol OwnedConlractodAulhorized Agen� Dalo � <br /> � L <br />