Laserfiche WebLink
PERMIT APPLICATION <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 B AM TO 4 PM 9 <br />SITE ADDRESS �.V• <br />-tT <br />PARCEL TAX I.D. # <br />PERMIT # <br />1 2 v a l.�a S <br />LEGA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION If <br />DESC. <br />OWNER ADDRESS CITY2IP PHONE 42573S5.1-7 fI <br />Fyoyt\� MOM ' \UO2 _1Lv-U_eft W& 1�.,' <br />TENANT NAMEn <br />CONTACT FOR PERMIT PHONE I.�C>.(.ISI'7(OIC 1 <br />��l✓ (�� <br />3e56\CaRob1hw�0n EMAIL tfsslcaecrownfp. <br />CONTRACTOR ADDRESS CITY2IP PHONE <br />CY'O\-O'1 F1YLFY0�tCt10Y1 ?0 eQ?C 12-11:?, Li2G'4$I•7669 <br />CONTR. LICENSE # <br />G:OWNF�'CqyLL_ m�l� Creek,l>,P� 9Z082 <br />USE OF BUILDING HEAT SOURCE PRICE OF WORK <br />{CONTRACT <br />>�p��U,\ N ,^11 C�f,�_Electric —Gas —Other 3�qcaco <br />( <br />WORK DES i; R I PTI O�1 <br />9\4d l,? hems <br />IZelocr�� 3 heeds <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />_ <br />Bathtub <br />_Forced <br />air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />Shower <br />Water heal <br />_ <br />_ <br />Kitchen sink &disposal <br />_Gas <br />fireplace <br />Dishwasher <br />_Gas <br />range <br />_ <br />Clothes washer <br />_Clothes <br />dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_Exhaust <br />fan <br />_ <br />_ <br />Backllow preventer <br />_Heat <br />pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />_Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />_Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Co tractors Law 18.27 RCW and 296.200 WAC. <br />Signa re o OwnerlCentr tier/Aulhodzed Agent Date <br />