Laserfiche WebLink
4 -i � -ofo <br /> PERi1JIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACC=PTED FROM 8 AM TO 4 PM �G ZG</- <br /> SITE ADDRESS L PARCEL TAX I.D.iF PE � /� <br /> � i',;'v (� � i?�j ��,1 `1j: '`V , ""GG <br /> IEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER I AODRESS CITYIZIP PHONE <br /> ` 1 i n'� �� L- � � .,n 4JL -- <br /> TENANT NAME � I GO FOR PERMIT PHONE <br /> 'rr�� �,(�Cn (. Z��-� -�a I .T� r�s�r� 42s �SQ � �6 `{ <br /> CONTRACTOR W O C fGLF'1'i p I l'� A RESS �E CITY2IP PHONF. <br /> � � P� �z � ,���s� � �e��a ��6 �q �y <br /> CONTR.LICENSEN 1����I.•�f PL�>�» ��� �u ' C � E U62� <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleclric Gas_Olher � �(/ � <br /> WORKDESCRIPTION ���1-�!� � i � ,.�_Yi n ��i r�= � � l �'Yl � i l,A. 1"Yl � f I'Z�( • <br /> i� <br /> ' \1 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet __ NC—air handling unils <br /> Balhtub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Walerheater <br /> Kitchen sink 8 disposal _ Gas(ireplaco <br /> Dishwasher _ Gasrange <br /> Clolhes washer _ Clothes dryor <br /> Water healer _ Range hood <br /> Sink(service/bar/mop/elc.) _ Exhausl(an <br /> Backflow prevenler _ Heal pump <br /> Urinal _ Unil healer <br /> Drinking Fountair. _ Boiler <br /> Floor drain _ Refrigeralion <br /> Grease trap _ Woodstove <br /> Roof drains _ Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> I hereby ceritity lhal I have read and examined lhis application and know the same tc be We and correcL All provisions of laws and <br /> ordinaces g�verning lhis type of work>vill be compiied with whelher specilied herein or noL The granting of a permit does not presume <br /> lo givo authorily to viol3te or cancel tfie provisfon of any other state or local law ieguiafing construclion or the performance of <br /> consWclion.Thal 1 am authorized by lhe ownor of lhis property to perform the work for which application is made and I comp!y wilh the <br /> State C:onlractors Law 1827 RCW and 296.200�(VAC. <br /> �'-- - ---- - 1'� � �' �-�l -0� <br /> Sign �re of OwnedContraclor/Authorized Agenl Date <br /> �(\ <br /> 1 <br />