Laserfiche WebLink
� � <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88t0—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T0 4 PM <br /> SITE AODRESS d�„!ti PARCEL TAX I.D.N R 1 N /y� <br /> _T ..-� ' [.G'� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> TEN�N� CONTACT FOR PERMIT PHCNE <br /> Wu�,� �Jl, �• 2�'. 3Z5 •2�3 <br /> CONIRACTOR ADDRESS CITY2IP � PHONE <br /> � <br /> CONTR.LICENSE t <br /> USE OF BUILDING ( — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric _Gas_Other I � �q'��� <br /> WORK DESCRIPTION ��y� � �� � /.,fu� '� Z �V <br /> ��'�R q�►WbbS liv G1W� W411, hM� $U l�-►'j WP�� ��'1���� <br /> T�T #�R W� 'I�51'IM� �t. �. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIl(TURE OR fTEM <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 hreplace <br /> I _ Dishwasher _ Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sirk(service/badmap/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floordrain _ Refrigeration <br /> Grease trap _ Woodstove <br /> Roofdrains � dther <br /> — ane� — <br /> CITV Of EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> I hereoy ceritify that I have read antl examined this application and know the same to be true and corrsd. All provisions of laws and II <br /> ordinaces governing this type ot work will be rqmplied with whether specified herein or not The granting of a pertnit dces not presume � <br /> to give authority to violate or cancel the provisbn of any other state or local law regu�ating wnsWction or the Fsrformance of <br /> conshuction.That I am uthorized by e owne�of this property to pertorm the work for which application is made and I compty with lhe <br /> State C ractors aw 82�W a 296200 WAC. <br /> I ��,7.0� <br /> Signature OwnedContractor�fhorized Agent Date y / ��, <br /> � — — -- (7� <br />