Laserfiche WebLink
i �ERMIT APPLICA,TION <br /> CITY OF EVEL2ETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCCPTED FROM 8 AM TO 4 PM �'J�-�� "�� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT q <br /> ,� 1f��/' /�v LCih OG.s? �qOC�t����o O �j ,�V� : <br /> LEGAL� LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER � r qDCRESS 5U4 S`T�n CITYZJP ' 'N �P�ONE <br /> � l 5�4� � C XY�!�7� ��°7�4 c(✓Ct l.lt c Y LL � t `'� �'� , <br /> TENANT NAME CONTACT FGR PERMIT /�Z s PHONE <br /> I�"Sl4 iv C x i�;�S� �Y'�7�Yu�c..�- �l 6ti'J 1'���viac2 �7-2 ,'?o c� <br /> CONTRACTOR ADDRESS CITYI�}-� PHONE L <br /> Tlf�5%'rP�/ J-�n�-/'r,. �/.S- $'''+ '�T �r�n<<dJ �U �2� <br /> C TR.LICENSE# � � `�'C� �'2`��� <br /> ��94�-02 v i i� <br /> USE OF BUILDING HEAT SOIJRCE CONTRACT PRICE OF WORK <br /> �'{z'�� `C I _Electric _Gas_Other y� SE7d • U C� <br /> WURKDESCRIPTION ��f�.i � � /,--, �x-t� _/� 'r �LL_C(u-�l N�f�.�fj/ �C.� (�. <br /> ��GJ /L y <br /> ���t�f S <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> lodet A/C-airhandling units - <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) G�s piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gss fireplace <br /> Dishwasher G2s range <br /> CWthes washer Clothes drye� <br /> Laundry lray � Range hood <br /> Sink(service/bar/mop/e;c.) Exhaust fan <br /> BackBow preventer Heatpump <br /> Urinal � Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refigeration <br /> Greasa trap Woodstove <br /> Roof drains Other <br /> Other <br /> I <br /> iCIIY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the sama to be t;ue and corcect. All provisions of laws and <br /> ordinaces governing this rype of work will be complied with whelher specified herein or�,ot The granting of a pertnit does not presume <br /> i to give authority to violate ur cancel the provision of any other state or local law ren--�'�Sng construction or lhe pedormance of <br /> � co rur.tion.That I am authorized by lhe owner of this property to perf,rm lhe wu�.. -which application is made and I comply with the <br /> i St t Contra tors . w 1827 RCW and 296200 WAC. <br /> � � � /D o� <br /> Si natur o Own Y. ntrac or/A orized Agent ate <br /> '/L <br />