Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT :ERVICES � �� �,� <br /> 3200 CEDAR STREE7, EVERcTT, V�'A 98201 <br /> ! 425-257-8810- FAX 425-257-8857 -www.everettwa.org <br /> I APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I SI1"L ADDRESS PARCEL TAX I.D.M PE MI M — <br /> � � <br /> o� W CGS� rIo � �� <br /> LEGAL LOT NO. j BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE �r. <br /> ��, <br /> C��Si�,�� ��Fao1P1"j So� w C �iS;ho Y�1 �✓erRl� �-�-A 4�� - �l'3 - S�' lo <br /> TENANT NAME CONTACT FOR PERMfT PHONE �Z�J".. 076 v <br /> O �9. v�Y1 p��Yk I �.c�� Myl./ h� �� E-MAIL V��lS�5� 9�� '� S/Q�w� <br /> ---�1T�7Y `-�� <br /> ���--� � � A � ���w-�.�� w.a 9� �'y <br /> wh � z�=- tis,q ;�, - � S� °� K Y49 y <br /> CONTR.LICENSE N w ry' �� �' 7 O� � �, .j (� ��- 7 �r � �6� <br /> I <br /> USE OF BUILD�NG HEAT SOURCE CONTRACT PRICE OF WORK <br /> �i I�J`� _Eloc�ric __Gas__Olher �(IL� <br /> WORR�[SCRIPTION ^1 �.I � C, G � ��.� S n,�,� S11 '�-� w ���`'� <br /> I � �� ,� . <br /> --- PLUMBING MECHANICAL <br /> ��p. TYPE OF FI%TU�.E OR ITEM NO. TYPE OF FI%TUPF.OR ITEM <br /> �loilnt — fVC-air handling units <br /> Balhlub _ Forced air syslems <br /> Lavalory (Wash basin) __ Gas pipin� <br /> Shower _ Wa�or hoater <br /> I Ki�chen sink 8 disposal __ Gas liroplace <br /> I __ Dishwasher � Gas range <br /> Clolhes washer Clothes dryer <br /> ' W�ler healer __ Ranyo hood <br /> Sink(scrvicc/badmopletc.� _ Exhau,tfan <br /> 6ach�low prevenlcr _ Heat pump <br /> Urinal __ Unil healer <br /> Drinking Fountain _ Boiler <br /> Floordrain _ Relri�era�ion <br /> Groase lrnp _ Woodslovo <br /> Roof drains _ Olher_ __ <br /> — o�r�er_______ — -- <br /> ICITV OF EVERETT LOCAL SALES TAX CODE IS J105 _ <br /> III heroby ceri�ify Uial I havo read and oxamined Ihis applicalion and know tY e samo to be lve and corrocl. All provisions of laws and <br /> ordinaces govemin�lhis type o�work will be complied wilh whether specilir.d herein or nol.Tho granting ol a pormil does not presume <br /> Ilo give aulhority to violate or cancel lhe provision of any olher state or local law rec�ulaling�onslruction or the perforTance of <br /> conslruction. Thal I am aulhori;:ed by Ihe owner ol this property lo perform�he work lor which applicalion is made and I compty wilh lhe <br /> � Slale Conlrar,lors Law 7�7 RCIN ai 1 J6;2Q0 WA / � <br /> ; l i x i� �- ,, �--b� � <br /> � Slgnaturcr ol OwnedConlraclnr�AulhorizeA AgenY �,�e <br /> I <br /> �' --- <br /> I .. _.. . .. _ _ _. _ . - � ----_ _-�--__ . ------- <br />