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-N.�ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (7-I b��� <br /> SITE ADDRESS � `� PARCEL TAX I.D.N PERMIT p <br /> %�3 w- c�; „N �, ,�� I � 3DX�-Zb� <br /> If:GAL LOT N0. BLOCK iRACT OR SUBDIVISION p <br /> DI:SC. <br /> OY/NER ADORESS CITV2IP PNONE <br /> �7�tiv ����7 <br /> TEH4NT NAME CONTACT FOR PERMIT �/ PHONE ,/ <br /> {- rt� 72S �� � n397 <br /> L)��Li � � "�� S 7� �6/�,��'J E-MAIL <br /> 'Z`'bAT4ACTSl�- <br /> G�,�-,l �%1E�-l. i.,�� c �',:5 �-. cr <br /> CONTR'.LICENSE N <br /> �.1.� ti c�lSo�� 4✓ <br /> USE OF BUIL�ING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> �To/1�F- �r�U( . VaJr � _Eloclnc _Gas_Othor �5�� �I 0 d <br /> WORK DESCRIPTION <br /> .- <br /> �'�l/� .I � r' C _ 2��;I <br /> i_' e%_u,c � jnnl, `;/l•- c� � <br /> PLUMBING MECHANICAL <br /> NO. IYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C-alr handling unils <br /> E3athtub Forced air eystems <br /> Lavalory (wash basin) Gas piping <br /> Shower Water healer <br /> Kilchen sink 8 dispos.d Gas tireplace <br /> Dishwashor Gas range <br /> Clothos washor Clolhos dryer <br /> Wator hoator Range hood <br /> Sink(service/bar/mop/elc.) Ezhaust lan <br /> 8ack0ow proventcr Heal pump <br /> Urinal Uni�heator <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease Irap Woodslove <br /> Roof drains Olher <br /> Olher _ _ _— <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S]105 <br /> I her�by ceritify that I have read and�zamined this applicalion and know thn same to be true and correct. All provisions of laws and <br /> ordinaces govrminc�Ihis type of work will be complied with whethor spocified herein or nol.The granling ol a pormit does nol presume <br /> to givr authorily to violate or cancel the provision ol any other stato or local law rogulaling construclion or the peAormance of <br /> conslrur,tion. That I am aulhorized by tho ownor of this proparty lo peAorm the work for which application is made and 1 comply wilh lhe <br /> Stat Conirar,(ors La �1�7 RCW d 29(i.1J0 WAC. <br /> ,�_d1-.2� � � ('s� rr..�� S�7 j�n�' <br /> 'Signature ol OwnedConlractodAuthorized Hgont Date <br /> �Z <br />