Laserfiche WebLink
_ �2 —"���04 <br /> P�RMIT APPLICATI�,N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820 i <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOl'ACCEPTED <br /> SITE ADDRESS � '(� �� CO� /}i-tt' PARCEL TAX I.D.!f PERMIT# <br /> S,.� i f� � XU`�lZ-Ul I <br /> LEGA LOTNO. 6LOCN TRACT <br /> DESC. <br /> OWNER A�ORESS CITYfZIP PHONE y2�- 7,S'3,— <br /> 5'/d G <br /> S���c� ��u- � �� i� s�z�c l�U �dK 5 %1�7 �✓����lJ� 1`�,2a L� — — <br /> TENANTNAME CONTACTFOR PERMIT PHONE � <br /> 5,��a// Wo �/� C� �ir.c..(a.��.� g <br /> cln�� �P �G �U � C �]��� l,�i'��( JLv '7! y' ��'Z� <br /> CONTRACTOR (�U � f� ��,( ,v� S I✓�y ADDRE55 Gi.TY(LIP PHONE <br /> : 7?zi i� rffS,.l: ;Mr:nro� 3Go - 79Y- .:(z/ <br /> CONTR.LICENSE# <br /> woc rc✓'2 � 33CT <br /> USE OF BUILOING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> (' , „� �,,� r� � � � �ElecMc G 5 Other f d /Y� <br /> WORK DESCRIPTION ' <br /> ( � l Z�� ��� - <br /> PLUMBING MECHANICAL <br /> N0. TY?E OF FIXTURE OR ITEM NO. TYPE OF FIX7l1RE OF.ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air svstems <br /> I = Lavatory(wash basin) Gas piping <br /> Shower = Walerheater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clofhes washer Clothes dryer <br /> Laundry tray Ranye hood <br /> 1 Sink(servicelbarlmop/etc.) Exhausi fan <br /> Backflow preventer Heat pump <br /> Unnal Unit heater <br /> Drinking Feuntain Boiler <br /> � Floor drein Refrigeration <br /> Grease trep Woodstove <br /> Rocf drains Olher <br /> Other <br /> I CITY OF EVERETT LOCAL SALES TAX CO�E IS J705 _ <br /> I hereby centify that I have read and examined this applicatlnn and know the same to be true and correct. All provisions of Iaws and <br /> ordinaces goveming this type of work will 6e complied with whether specified herein or not.The grantinc+of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or Incal law re9ulating construction or the performance of <br /> construction.That I am authorized by the owner of this property to peAorm the work fer which application is made and I comply wdh the I <br /> Slate Contrac:ors Law 18.27 RCW and 296200 WAC. <br /> l t; c� Cl L..� d ��� l 2- �,2-�y <br /> Signaturs o OwnerlContractorfAuthonzed Agent Date /�/ `�, I <br /> � --�-J � <br />