Laserfiche WebLink
P'tRMIT APPLICATI(�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810- FrU(425-257-8857-www.everettwa.org <br /> ����S pPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S �a�`� <br /> SITE ADDRESS,� ��lJ , � PARCEL TAX I.D.# � PERMIT# <br /> ` b8b5 - <br /> �J�j � �i<'�n � Zi{rm.o �� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. — <br /> OWNER ADDRESS CINIZIP PHONE <br /> �'� .Y ii1 ° _ � <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I I <br /> E•MAIL � <br /> CONTRACT R ADDRESS CITY/ZI H NE <br /> /p <br /> CONTR.LICENSE# �i� ����� � <br /> IUSE OF BUILDWG HEAT SOURCE CONTRACT PRICE OF WORK <br /> C�f���,�. � _Electric _Gas_Other �� �� � <br /> WORK DESCRIPTION ( � �� ; / ,�/ <br /> �,/� ��� /' ",-�A�i `-�-{�( L�'2 -. �� C �f O <br /> // \ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ 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 /> Dishwasher _ Gasrange <br /> Clothes washer _ Clothes dryer <br /> Water heater _ Range hoad <br /> Sink(servicelbarlmop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain . . _ Boiler <br /> Floor drain _ Retrigeration <br /> Grease trap _ Woodstove <br /> Roof drains � _ Other <br /> I _ Other — — I <br /> GTY OF EVERETT LUCAL 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 wrrect All provisions of laws and <br /> ordinaces goveming this type of work will be complied v�ith whether sper,ified herein or not.The granting of a permit does not presume I <br /> ! to give authoriry to violate or cancel the provision of any other state or local law regulaling consWction or the performance of <br /> conshuction.That I am authorized by the owner of this property to perform 4he work for which application is made and I comply with the <br /> II State Contraclors Law 1827 RCW and 296200 WAC, <br /> I <br /> ��, SignaWre of OwnedContractodAuthorized Ayent Date <br /> f�-- -- ---�--- ---- — —.I <br />