Laserfiche WebLink
PERMI� APPLICATION <br /> CITY OF EVEHETT 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 TG 4 PM (� ���-U� <br /> SITE ADDRESS � PARCEL TAX I.D,p PERMR# <br /> 91� F �,tL� W� .;�. S 7a� -r�� <br /> LEGA LOT N0. B OCK TAACT OR SUBOIVIStON# <br /> DESC. <br /> OWNER ADDi7ESS CITY2IP PHONE <br /> �_,�r�,$ yi2o E��,�.zr... w�� ��� ����3 <br /> � <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I 3�r� - g�o-i5�'r l <br /> �r. �I�S Sa:vLr 4�.r......r <br /> � <br /> 1 e�a�o%y.-.-,p�cs��c.�...u.� :,c. <br /> �6ATR7C , <br /> SS <br /> 6!y..,.�;c. 5��� �r��cr 5 27�: �2��,(�� �jr O/ r..��'�c 3Gu-7�3-1�L��� <br /> COMfFi.LtCENSE <br /> ���4�MN�5 > 9�ZR9 r9 5>>n � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��,,..y,..{.,�L���� _Electric _Gas_Other �� �C� <br /> WORK DESCRIPTION * / • 1 <br /> �. / ��,,, e,-�'�..II� L'I(6..W�v�.J 5 cavi�y <br /> ,;Y, s�r.t f ; ;� .-..S /e.ffi• / G.ow/v� I <br /> Ce�"•n�--{ `To cf�v�i�.rftd' [U'"c+Jr'I'c <br /> PLUMBING MECHANICAL <br /> NO. TYPE UF Fll(TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet NC—air handling units <br /> Bathtub Forced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kilchen efnk&disposal _ Gas fireplace <br /> Dishwashor Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(servicelbarlmop/elc.) _ Exhaust fan <br /> Bachllow preventer _ Heat pump <br /> Urinal Unit heater <br /> _ DrinkingFountain — ������rryeu �„ [o complianco witn <br /> _ Floordrain Relin,�p($yonSEPA and discretionary per�, <br /> _ Grease Irap ._ Wo4�5�Q� .� � <br /> Rool drains Olhcr � <br /> Olhor � � <br /> -- — --n o,�l b rTI <br /> — — � , � : �. <br /> CITY OF EVERETT LOCAL SALES TA%COOE IS 3105 <br /> I hereby ceritify�hat I have read and examined this application and know the samo to be true and r,orrect. All provisions of laws and <br /> ordinaces goveming this[ype of work will be complied with whethor specilied herein or not.The granting o(a permit does not presume <br /> to giva authoriry to violate or cancel the provision of any nther state or local law regulating construction or the pedormance of <br /> construction.Thal I am authorized by tho owner ol ihis pmpe:ty to pedorm the work lor which application is made and I comply with the <br /> State Contractors Law 1827 RCW and 296.200 WAC. <br /> S�GUC.� ,Ct...........c-�- f--.._�.�Q --� <br /> � <br /> SignaWre ot Owner/CoNractor/Authorized Agent Date <br />