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 �Z�� `-'D6 <br /> SITE ADDRESS I PARCEL TAX I.D.8 PERMIT A <br /> ���D la-�� � <br /> LEGA L0T40. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS CITYIZIP PHONE <br /> ';`—I c� w���r �<<_ � l Z fJ <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> lU'e �2 C7��y�G C � <br /> CONTRACTOR �.�t�,t��i,t:,.� C'_'� <<`5��-�'..� �.ADDRESS dTYIZIP PHONE <br /> ` I� 2.1� °>1;z,�;.>o�) -1�._� q_p �4L�- �Rl "l9�iD <br /> CONTR.LICENSE N -, <br /> ic f-`��!-t�i2 `L-q'-l�1 � r�� � �i Z.Z � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �n � ,� _Eloctric _Gas_Other � � �'j � <br /> 7 � f�. I� Y � �c r` ` <br /> WORK DESCRIPTION L y��C �` L VG.1r,� „�; c�v � L l� u � <br /> \y,�, ."c_{-1.��`� � � v �� \ \ . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilcl A�C-air handling units <br /> Dalhlub Forced air syslems <br /> Lavalory(wash basin) _ Gas pipiny <br /> Shower Waler healor <br /> Kilchen sink 8 disposal _ Gas(ireplace <br /> Dishwasher Gasrange <br /> Clothos washer Clo�hes dryor <br /> Walor hoaler Rn,ige hood <br /> Sink(sr,rvicc/bar/moplolc.) _ Eanaum(an <br /> Back(low prevenlnr _ Heal pump <br /> _ Urinal _�l heater <br /> Drinking Fountain � Boilor <br /> floordrain � Rofrigoration <br /> Groaso trap Woodstove <br /> Rool drains O�her <br /> — oir��� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cerilily that I have read and ezaminr,d Ihis application and know the samo to be true and cortecL All provisions of laws and <br /> ordinaces c�overning lhis lypo ol work will bo compliod with whether specifieA herein or not.The granting ot a permil does nol presume <br /> to givc authority to violato or cancel the provision ol any olhor slale or local law regulatinc�consiruclion or the peAormance of <br /> cunstruclion.Thal I am aulhorized by ihe owner ol lhis proporty lo pedorm tho work for which app�icalion is made and I comply wilh lhe <br /> State,6oniraclors Law 18.27 RCW and 29R.200 WAC. <br /> � , ., `�L.--_ l ' ��� �o z� <br /> Signatu ,of Ow �dConlractorlAuthorized Agent � Date <br />