Laserfiche WebLink
P��MIT APPLICAT'10�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV�RET�f, WA 98201 <br />425-257-8810 — FAX 425-257-0857 — www.everettwa.org <br />/o -7--07 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT � <br />76 c� � � v�= ki:�� E�r�, (.l�il Y _ C i( i v- ��o : <br />LOT NO. I BLOCK I TRACT <br />+i � �'� �'�c C k_ <br />� <br />�G��I �.��c��C���c-�N �A1'� � <br />rn�nt 355 G� 1e <br />�- `��'��.3 Y25= <br />TENANTNAME CONTACTFORPERMIT PHONE <br />��� � l.1 ? ti <br />�;��, ,.� � 5�- c i f � 1( =�l _.11.� 7_5 G o��- �i <br />CONTRACTOR � I �.,� ADDRESS CITY2IP PHONE <br />��i (�C-� �Y%-c.'h(- ._-,IG i��c^ �� Si� ; -�,,� 2 �="r7 `���cc 75c ��z�/ <br />CONTR. LICENSE # <br />USE OF BUIL�ING ' I <br />�-�-P �ZL�J' I <br />WORK DESCRIPTIUN <br />�r% /� � ��� <br />HEAT SOURCE <br />_ Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />�s v' <br />PLUMBING MECHANICAL <br />NO. I TYPE OF fIX7URF OR ITEM <br />ioilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink R disposal <br />Uishwasher <br />Glothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backilow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease i; ap <br />Roof drains <br />Other <br />i:�. I TYPE OF FIXTURE OR ITEM <br />f�/C.—a�� .`,^"�'I"�;� UflllS <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Waodstove <br />CITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this applicatioe and know the same to be hue and correct. Ail orovisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The grenting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating consWction or the performance of <br />construction. That I am authorized by the owner of ;his preperty to perform the work for which application is made and I comply �vith the <br />Slale Contraclor Law 18.27 RCW and 29G200 WAC. <br />���' i,ti'I � ��- � " <br />� ,-�� „ _ � � -�i� ; � <br />Signatura of Owner - ntracror/Authorized Agent Date �� Z <br />