Laserfiche WebLink
� PE�2MIT APPLICATIO�� <br /> I GTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 -www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE61T 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAl(I.�.M PE IT# <br /> /.i•i C (As ,ti.o o� �-o0'�'�3C�'so;so:,fc�i95�.�o5alS�/ J - <br /> , LEGA LOTNO. BLOCK TRACT <br /> �ESC. � I�iC�JZ-013•u� c.)'/✓�LJ'��� ?J.J " �/ �= .N <br /> OWNER ADDRESS CI /ZIP PHONE <br /> � �1 . / <br /> /"licN,fsc. ��//,G.�4-r1i i�o r3.'k 3c�:. A/boi3 �2....F;�FI/i•'�4�/3 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> � <br /> CONTRACTOR, �^ AODRE55 T CITY21 PHONE <br /> �[j�.U� iC,�Cs�vvS� �✓G '��V�'X Sc�� 'JJ�/A'.[, �}fb/ �7.r+[� fl�i- �'��S <br /> CONTR.UCENSE N <br /> 'r3�v6 a.e I 9Y� T r <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> SF � Elactric �Gas Olher <br /> WORK UESCRIPTION <br /> �t� �"'J %w'AH� J7Nfnt(s /�/�-ti�� �..S/ DlriVC+.� �_>iG �I�l <br /> PLUM2ING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> o Toilet Al.-alr handling unils <br /> � Bathtub —T Forced alr systems <br /> Lavatory(wash basin) � Gas pipinq <br /> Shower �- Water heater <br /> Z I(itchen sink 8 disposal � Gas fireplace <br /> � Dishwasher Gasr�nge <br /> _,� C�olhes washr.r _L C�othes dryer <br /> _ laundry tray � Ranpe hood <br /> 8ink(service/bar/mop/etc.) �_ Exhausl fan <br /> . BackOow preventu Heat pump <br /> Urinal Unit heater <br /> Drinkiry Fountain Boiler <br /> ^ Floor tlrain Reinge�tion <br /> Grease trap Woodstovo <br /> � Roof drains Other_ <br /> Other _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J10S <br /> I hereby ceriti�y that I have read and nxamined this application and know the same ro be true and correct. All provisions of laws and <br /> ordinaces govcrning Ihis type of work will be complied with whether specifiec herein or not The grantlng of a permit does not presume <br /> lo give authonry to violate or cancel Ihe provision of any other stale or local law regulating ccnstruction or the performance of <br /> construction. hat I am authonzed by the owner of this property to perform the work lor which applicaGon is made and I comply wilh the <br /> State C:n!rac rs aw 18.27 RCW an 296.200 WAC. / / <br /> c� Ct � a ' �t_ `f• �`'O�•-� <br /> ��gnature of wnen ontractouAuthonzed Agem ate �L <br /> � /•1� <br />