Laserfiche WebLink
�ERMIT APPLICATIVN <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 j� � Db—� <br /> SITE ADDRES$ PARCEL TAX I.D.# PERMIT# <br /> �f�'c� 9� ��v��� ���� c� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBQIVISION# <br /> DESC. <br /> t OWNER ADDRESS CITYI^cIP PHONE <br /> �ogo� - 03 � ' <br /> _�.nr+; ;, <br /> ..l—�'��r'�.��r�.� 1rY r 3 — �c;c:_� �.�r C <br /> -'.tE COHTACTFORPERMIT PHONE ,�16(c 3� j 035'S <br /> ; I <br /> � � �-�r; <br /> � . 1-, .��USt 'l[C� �uwv� E-MAIL <br /> C�3KT:�lCTOR A�DRESS CITYIZIP PHONE <br /> � <br /> �I��-�-eau ��eChu���Cal �.o. �ax ,y3 ���,..�lo� 3c.ogoJ H3�(.� <br /> CONY�. LIGi�.;�z r <br /> , -I�la ' c .� �•' oogPv vul� <br /> �g:OF 8l�liy_��ING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���/ �oS��„+ n,� � _Eleclric _Gas_Ofher �� � <br /> WORK DESCRIPTION <br /> '�.�� rj f �vrx� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel ' A/C-air handling units <br /> Bathlub Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clo�hes dryer <br /> _ Water healer � Ranc�e hood <br /> Sink (service/bar/mop/elcJ _ Exhaust fan <br /> Backtlow prevenler Heat pump <br /> Urinal Unil heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease lrap Woodslove <br /> Roof drains Other _ <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I hereby cerili(y that I have read and examined this application and know the same lo be true and correcl All provisions of laws and <br /> ordinaces goveming this fype of work�vill be complied wilh whelher speci(ied herein or nol.The granling of a permil does not presume <br /> lo give authorily lo viol le or cancel lhe provision of any olher stale or local law regulating conslruction or the pedormance of <br /> construclig�'� at �aulhorized by the owner of this property to perfor the work for which applicalion is made and I comply wilh lhe <br /> Stale C�lractors 18.27 RCW and 296.200 WAC. � <br /> � C� l <br /> o �; �; <br /> Signal re ot �.vner/Conlraclor/Authorized Agent D�e 1 <br /> /L <br />