Laserfiche WebLink
I�ERMIT APPLICATtuN <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 PARCEL TAX I.D.# PERMIT 1i <br /> v�iLi �3LHcK toni�5r INNE O(V�S-01 <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> � vr.' a�S,a �cck�2 ti�12� �s�-Nc� ta.tGST L.aN� ����tc � „�a q�u' 3 <br /> TENANT NAME CONTACT FOR PERMIT PNONE <br /> CONTRACTOR �A�. �, ADORESS CITY2IP PHONE <br /> CONTR.LICENSE# AL�S+�S�q$5��� ZC�6'b � ���SL.�- 5.1�2�'YS N,��� ���y�LL. w'a G�CLI <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �„Electric X Gas Olher � i0ec - �;� S. 6ee <br /> QnS� )�z`.]i Al <br /> WORK DESCRIPTION � � <br /> �L�«�;��..Jq - TC �Liz1'� 'Y���3 fl� r„J � S�w� Sho,.:.e� OriN.i�� �tL- <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. 7YPE OF FIXTURE OR ITEM <br /> `� Toilel A/C-air handling units <br /> � Bathtub Forced air systems <br /> �! Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> � Kitchen sink&disposal _ Gas fireplace <br /> _�c Dishwasher _ Gas range <br /> Clothes washer Cbthes dryer <br /> Water heater Range Frood <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain � Boiler <br /> � Floordrain _ Rafrigeration <br /> Grease trap . _ Woodstove <br /> Root drains Other <br /> Other <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whelher spec'fiied herein or not.The granting of a pertnit does not presume <br /> to give authority to ' te or cancel the provision of any other state or local law regulating construction or the pertormance of <br /> construction.That I m a thorized by the owner of this property to perform the work for which a{tplicatlon is made arW 1 comply wfth the <br /> State Contrt�ctors L w t .27 RCW and 296.200 WAC. <br /> � S Z2 C b <br /> Signature f er ContractoNAuthorized Agent Date <br /> \ <br />