Laserfiche WebLink
-. <br /> ( � <br /> � PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 98201 �r ap�S <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM �U5GC1 O�{� 4N� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT K <br /> Z81y f��d r. ooy39/66 0/ 900 !- � <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY(ZIP PHONE <br /> Fu« 6osPe� M►s��.�/ ��y 21i4 Gout��*'F E✓[^�>f 9fz.� �t�b� zzt-�iil <br /> TENANTNAME <br /> I CONTACT FOR PERMIT PHONE <br /> �S4�,F� • SrE✓E v�r��u�✓ (�� �Pa-�l�v <br /> CONTRA TOR n/����� C��n/ ���J ADDRESS CITY2IP PHONE <br /> � IZSSI✓���A'F�✓. S�'I�>�F[� 2�)Z!Z-0108 <br /> CONTR.LICEHSE� �✓9�pSC0?/� 9'��0 / C <br /> 7 <br /> USE OF BUILDING HEAT SOURCE CO RACT PRICE OF WORK <br /> I � Electnc _Gas_Other .��2� � <br /> WORK DES��17� odE 5�.���� f+7CF �(,C4M�.�'7Gp G�^!sZ Ji�.✓ D�'3/�f/ ' <br /> PLUM8ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> NC-air handling units <br /> Toiiet � Forced air systems <br /> _ Balhtub � ��t � Gas piping <br /> _ Lavatory(wash basin) � — Water heater <br /> Shower � Gas fireplace <br /> _ Kitchen sink 6 disposal 1� _ Gas renge <br /> = Dishwasher �^ { Cloth=_s dryer <br /> Clothes washer I Range hood <br /> Laundry tray Exhaust fan <br /> _ Sink(servicclbar/mop/etc.) — Heat pump <br /> Backtlow preventer Unit heater <br /> Urinal — Boiler <br /> _ Drinkmg Fountain — Refngeration <br /> Floor drain Woodstove <br /> Grease lrap Other <br /> Roof Crains — <br /> Other_, — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby cerit fhat I h read and ezamined this app6cafion and know the same to be irue and wrrecl. All provisions of laws and <br /> ordinaces g ming th' pe ot work vnll be complied with whelher specified herein or noL The g�anhng of a pertnit does not presume <br /> to give auth r y to viol t or cancel the provision of any other state or local law regulating construdion or the peAormance of <br /> construIXion. hat I a thorized by the owner of this property to periorm tke work for which appiicatlon is made and I comply Nnth the <br /> 5late Contra 1 27 W and 296.200 WAC. <br /> 9-12-0 <br /> Signature of erlCn ador/Authorized Agent Date �/ <br /> Z <br /> � <br />