Laserfiche WebLink
f =RMIT APPLICATf �N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810— FAX 425-257-8857—www.everettwa.org / 7 `�� —/� <br /> IAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS ��"�`� � PARCEL TAX I.D.p PERMIT It <br /> � i ' ' • • ; I i l � � C .(' � � �� ' c C� (nlul'd -OK "> <br /> � , <br /> , � � I � � � ' <br /> IEGA lOTNO. BLOCK TRACT - <br /> DESC. <br /> OWNER AODRESS CIlY21P PHONE <br /> � .. �I � �L � -'� - .�.�y� � �� J�� �� � � � � . � ; � � (._ � � � l � � <br /> TENANTNAME ` ��� 1 � �' '-�L1���' 'l jCONTACTFORPERMIT � \ PHONE <br /> � =t-, - , � a�j �; •�� � `; �� �� - �1�. Ct�� =,) <br /> �3 � + , � �� � I � � � � 1� � �111II� � � � " � � ;�i� � l :__ � � " � � � <br /> CONTRACTOI� 1'•,� i ADDRESS � ' '� ��l �' � �.(ZITY P PHONE <br /> � �\ Y \I 1 � 1V � � 1 � I � <br /> „ ; , �i � �� � � << �_�'- <br /> coHrR.uceHse• j �y �.' 1, i1 l� I l I � � . 1 _'11: -���L ��(���� I <br /> USE OF BUILD�NG HEAT SOURCE CONTRACT PRICE OF WORK <br /> Elect�ic _Gas_Othor �� � , � 1 �_ � �� <br /> ��I. (; �_ = - _ - <br /> woRK oescRiPnoH �,� ; �\ l�l ( I ; ' � �� l I _ � - � 1 l ('�I '1� '� '�l 1 ��`� C\ � X � <br /> � �, ;; � � ',���. � � � � I � � � ���� �.�� � \ �� (�� ���'`�.( ��� . <br /> ( PLUMBING MECHANICAL <br /> INp. TYpE OF FIXTURE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> Toilet _, NC-air h:mdling unils <br /> Bath�ub .__ Forced air sysloms <br /> Lavalory(wash basin) _ Gas piping <br /> Showsr _ Water healer <br /> Kitchen sink 8 disposal _ Gas firepla.e <br /> Dishwasher _ Gasrange <br /> Clolhes washer __ Clothes d�er <br /> Laundry tray __ Range hood <br /> Sink(servicc/badmoplcic.) _ Exhausl fan <br /> Backllow preventor _ Heat pump <br /> Urinal _ Unit heater <br /> Ddnking Founlain _ Doiler <br /> Floor drain _ Refrigere6on <br /> Grease Uap Woodslove <br /> Rool drains _ Olher_ <br /> Other_ __ — <br /> CITY OF EVERETT LOCAL SALES TA%CODE 13 7105 <br /> I lie�eby ceriti(y ihat I havo read and examined Ihis application and know the same to be irue and cortect. All provislons o(lewa and <br /> ordinaces governinc�this rypc ol work will be complied wilh whethor specified horein or not.1'he granting of a permft does not presume <br /> ln c�ive aulhonty lo violato or cancel the provision of any olher state or local law regulaling construcUon or Ihe peAortnence of <br /> �mstruclioa That I am aullrorizod by the owner of lhis properly lo pedortn the work for whlc7 applicatlon Is made and I wmply wilh lhe <br /> ,nlo Coniractors Law 1827 I�CW and 29fi.200 WAC. <br /> �� ' � �. � � �, � <br /> SignaWre o OwnedCoNraclor/Au horized��gent e�e /� <br />