Laserfiche WebLink
_ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everetlwa::;g <br /> APPLlCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADGRESS PARCEL TAX I.D.# PERMIT# <br /> .S/�9 EUzr' rean (.(� >S / 000d o f-oa �C� - <br /> IEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS CITY(11P PHONE <br /> �a�� s l' l�c-� ti�c, a�3� '78�/�i� � ��Z .�or /Z,ercerSs <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> �IQId� lGf r1���J �71L <br /> CONTRACTOR `Pve�q��.t�q vn/ ADDRESS CITYILP PHONE <br /> n C <br /> CONTR.LICENSEp c"�G fxe�me''��d �� <br /> USE UF BUILDING I — HEAT 30URCE I CONTRACT PRICE OF WORK <br /> EleIXric _Gas Other <br /> WORK DESCRIPTION � ' <br /> �t' n�U EX-i5'��t�� LX+nI��-� � Fue �� n9 �Qcr�� '� <br /> ���'�1 °� � C�Co YJ <br /> PLUM8ING MECHANiCAL <br /> NO. NPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling u nits <br /> BalhWb Forced air syste ms <br /> _ Lavatory(wash basin) _ Gas piping / <br /> _ Shower _ Water heater . ��/ S'(� <br /> Kilchen sink 8 disposel _ Gas Oreplece - / ' <br /> �ishwasher Gasrange <br /> Clolhes wesher Clothes dryer <br /> _ Laundry tray _ Range hood `� ���; <br /> Sink(service/badmop/elc.) _ Exhaust fan D�%pY? J J <br /> _ BackOow prevonter _ Heat pump � <br /> _ Unnal Unil heater �i, „ �,�-� ��. Q � <br /> _ DrinkingFountain _ Boilor � �1�� <br /> _ Floortlrain Re6lgeration � - �--� <br /> _ Grease trep Woodstove �(� _. �-/ <br /> Roof drains Other <br /> Other <br /> � CIN OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritiy that I have read and axamined this applicelion and know the same to be true and correG. All provislons of lews and <br /> orclinaces goveming this type of work will be complied wdh whet�er specified herein or nol.The granting of a permit does nol presume <br /> to give aulhority lo violate or cancel the provision of any other slate or local law reguleling construclion or the pertormance of <br /> construdion.That I am eulhorized by the owner of Ihis propeAy lo perform the worle tor which applicalion is made and I comply with the <br /> State Contr dors Law 1827.RCW and 298.20D WAC. <br /> i' j� � <br /> ;' i:,s�z /) c-��-�.1� %� //3 �o G <br /> Signature o(OwnerlContraclo;lAulhorizetl Agent e� <br /> � <br />