Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettWa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />�( r�+t8 ✓E ' er <br />24r65yt 050 2-4Ie0 <br />LEGA LOT N0. <br />BLOCK <br />TRACT OR SUBDIVISION A <br />DESC. <br />CITY2P PHONE <br />ADtfDRNES7/Sf <br />/OWNER <br />44jC,-p�iG✓G!!�Z` <br />if i�llAlf' L7 �)CiFJTTP. .- <br />TENANTNNAME <br />CONTACT FOR PERMIT PHONE />'25. 3Sfo •45/Y <br />pFN eocvK <br />C�lC. r f/4/bf+ G%i . E <br />I <br />L <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />f//�✓lr,Plft/,",7ZW5 PIH/37nL-r303 ?i"'A✓�.u�'�6.7Ar �iL g.- f' <br />CONTR. LICENSE# L��•r'E _swat-�+� i�I 9575•� 3��•�J27 <br />567CA/ �G3.t� 32c� ST Sc E E'✓rac x A-W QiP2o5� _ <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />_Electric ✓Gas_Other <br />�500�' <br />I <br />WORK DESCRIPTION a/2'x2Yr br-r/c sA j,t Le-4— A.J,>;y- �^r'"'rF• <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />_ <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />_ <br />Gas fireplace <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />BackBow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />_ <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boller <br />_ <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodslove <br />_ <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be ajmplied with whether specified herein or not. The yrantiny of a permit does nut presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to edorm the work for which application is made and I comply with the <br />Contr��a{{ctors Law 18.27 RCW and 296.200 WAC. <br />State Contractors <br />% <br />Signature of Owner/Contractor/AuthonzNd Agent Date <br />\U , <br />0 <br />