Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � ` .�5�_0� <br /> 3200 CEDAR STREET, EVERETf, WA 98201 __� <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org �\ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � � �/'�/ <br /> SITEADDRESS �'=�y-- G�""'-=� ''=y': t!i°' PARCELTAXI.D.# \ PEF�MIT� � <br /> �,�:�;--�:�;� a����r:- ' �,,,r,'�iidn�o-i9� �� �',,��.z�,�1 — D E6 <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION# - <br /> DESC. '7�� 1— `t O <br /> OWNER A�ORESS CITY2IP PHONE <br /> i <br /> y�'-+V%J l�+h'� i 71�5 Iv�i IZ6'" rr �zr�:�!�Mi /qh4 <br /> �Jis= <br /> TENANT NAME CONTACT FOR PERMITi PHONE ���' j. L j�_ , ; ; �!j <br /> � � 1% <br /> /�n �/� A�p .'„ sh,�- � <br /> t <br /> !// lVC�Y / l 1l E-MAIL i.l.-'?G`='�:°'r'L'A(�A� i . <br /> C TRACTOR ADDRES� CITY/ZIP �HONE <br /> ,��<c in��.. ,,,cy u�� #;s• - <br /> � /:,�.:'-' ;' , -�_'>. _ , _ , _.�;9 <br /> CONTR.LICENSE t! / } �/ /��.a� �?.^� 7 <br /> /'JI�L IMI�1`�/J O(�IU `''/!/i�{T/`✓ijii� I�� /i <br /> USE OF BUILDING HEAT SOURCE C6NTRACT PRICE OF WORK <br /> I �/Eleclric _Gas_Other ��'� ���' <br /> WORK DESCRIPTION , . . <br /> i � <br /> ;'rii7'e�,_ �'�„✓G-�'/1f (��`r)�'-'�—')� . <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handliny units <br /> Balhfub Forced air systenis <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes w.asher Clolhes dryer <br /> Waler heater Range hooJ <br />� Sink (service/bar/mop/etc.) [xhausl fan <br /> Back(low prevenler _ Heal pump <br /> Urinal Unil healer <br /> _ Drinking Foun!ain Boiier <br /> Floor drain � Re(rigeralion <br /> Grease trap Wooc:stove <br /> Roo(drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TNC CODE IS 3105 <br /> I hereby ceritify that I have read and examined ihis applicalion and know the same to be true and correcL All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whelher specified herein or noL The granting of a pen:iit does not presume <br /> to give aulhority to violale or cancel lhe provision of any olher slale or local law regulating construction or lhe periormance oF <br /> conslruclion. That I am aulhonzed by the owner of this property to perform the work for which application is made and I comply wilh the <br /> Stale Contractors Law 1827 RCW and 296.200 WAC. <br /> . <br /> _.--/� /���/03 <br /> Sighature of Dwned�orttra��� onzed Agent ' Date � <br /> . �f I <br /> I <br />