Laserfiche WebLink
�-cRMIT APPLICATIvN <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 —OU—D� <br /> SITE ADDRESS PARCEL TAJ(I.D.# PERM�T!! <br /> 2D21 Cle�elanc! o r � -o�� <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION M <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE �'j <br /> Dw�1ne � ��1 W�durC� ZD21 Ue.�r,ltinrJ �cre.lt �1 2°.Y� •4?z� <br /> TENAN AME CONTACTFOR PERMIT PHONE <br /> E-MAII <br /> t"�tch�S `.sPQ- b StovL L{�nnw� q0�3�o <br /> CONTR. LICENSE k <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleciric Gas ✓ Olhor �a� <br /> ��51C�C1Le. <br /> WORKDESCRIPTION �eplaaa "�('CG 5tc�ndillc� �,J(XJt� `J�Ve. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NU. TYPE OF FIXTURE OR ITEM <br /> Toilr.l _ A/C-alr handling units <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Walor heator <br /> Kitr,hen sink 8 disposal _ Gas lireplace <br /> Disliwaslior Gas rango <br /> Clolhes washer _ Clothes dryer !i <br /> Water healAr _ Range hood <br /> Sink(servicelbar/moplulc.) _ Eahausl lan I, <br /> �ackflow prevenler _ Heal pump i <br /> Urinal _ Unil hoalar I <br /> Orinking Fountain _ Boiler . <br /> Floor drain Relrigeralion <br /> Grcase trap _ Woodslova <br /> Roaf drains Other_ <br /> --- Olher__ — - . ' <br /> CI7Y OF EVERETT LOCAL SALES TAX COOE IS 7105 �' <br /> I hr,roby cr.rilily Ihal I have road and examined this application and know Ihe same to be lrue and correct. A�I provisions ol laws and I <br /> ordinaces govemin9 Ihis typo of work will bo complied wilh wholher spocitied horein or not.The granting of a permit does nol prnsume <br /> lo give authoriry lo violate or cancol Iho provision ol any olher stale or local�aw regulaling construction or Ihe perlormance of <br /> conslruclion.That I am authorized by lho uwner of Ihis property to periorm tho work lor which application is made and I comply with lhe <br /> Slate Coniraclors Law 18.27 RCW and 29Fi.200 WAC. <br /> ('/�n A-� I � �/,..� n Q'DF,C D9 _ <br /> SignaWra ol OwnodConlr .Ior/Au�horized Agen� Date <br />