Laserfiche WebLink
PtRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-881� — FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (� �l 6 � d d <br /> SITE AUDRESS � � = � PARCEL TAx I.D.# PER(J�IT N /� <br /> „)�� �'�,' (� /' S / ✓ �� P� � ��� � nJIP <br /> LEGA LOT NC. BLOCK TRACT OR SUBDIVISION p <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> �'�°����� . <br /> TENANT NAME CONiACT FOR PERMIT PHON <br /> lSui:� NC �j�i��l^'�rn �� �:. i �1�1� �i6 � 259`1 <br /> E�NIAIL <br /> ln2y �s^c��,No c<��s� <br /> CONTR.LICENSE ll <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> !i/L��(^� i���= <<� � Fledric _Gas_Other y[��, �1P0 <br /> WORK DESCRIPTION <br /> � ��'�.��-� G� <br /> �/� lr� r.a1_� w .'"�ilLc t,i�� <br /> PI.UMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilat A/C—air handling units <br /> Balhtub Forced air sys�ems <br /> Lavalory(wash baein) Gas piping <br /> Showor Wator heater <br /> Kitchen sink 8 disposal Gas lireplace <br /> Dishwashor Gas range <br /> Clothos washor Clothes dryer <br /> Water hoater Range hood <br /> Sink(service/bar/mop/elc.) Exhaust fan <br /> _ Backlluw prevonter _ Heat pump <br /> Unnal Unit hoater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeralion <br /> Grease Irap Woodstove <br /> Rooi drains Other <br /> Other __ <br /> CITY OF EVERE7T LOCAL SALES TAX CODE 19 3105 <br /> I horeby ceritify that I have r�ad and e,caminod Ihis applicalion and know the same to be true and correcL All provisions ol laws and <br /> ordinaces goveminc�Ihis type of work will bo complied with whether speci(ied herein or noL Tho granting of a pertnit does not presume <br /> lo c�ive aulhorily to violate or cancul lhe provision of any o!her state or local law regulating construclion or the peAormance ol <br /> construction. That I am authorized by the owner o(this proporty to peAorm lhe work for which application is made and I comply wilh Ihe <br /> State.,Con!raclors Law 8.27 RC and 296.200 WAC. <br /> �� , , � �� /� <br /> , •_. .. l �ri- \ �'I�� <br /> Signaturo of OwnedConhaclodAuthorized Agenl Date �/� <br /> ✓ <br />