Laserfiche WebLink
ERMIT APPLICATION � �i <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 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.i1 P MR M <br /> lO 3 E _s ,r ul � 00 0 o s'G� <br /> LEGA LOT N0. BLOCK TAACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITYlZIP PM NE <br /> aiqna�at0 TdSP_n�t �'� � :.�w�ro /� '�savl� J,+� ��/� Ev �'ar�Ct G.�ce%�� W� Q�Xf'/_ <br /> NANT NAME CONTACT FOR PERM�,T HON�y�,g�776-5�135 <br /> fVIQ2Gf�t � �J�fe� I CG.�s�oFGer E..r��yf neWotr�w��F�e:ry�aetis�jn �+., <br /> E�ANL <br /> 13B��y /l.�o.� S�y,n S�/5�e�n,S 7�/fX) a�deso.� Rc�/ t�Grtf4 i,J�t 98?d3 <br /> coNrn.uceNse• <br /> t3CR(1YNCm 77cM CY3�5�776 --ds�ss <br /> USE OF BUIL�ING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Ca. �ca e�s L��/� Eleclric _Gas_Other � �J � 7,�j_0� <br /> WOR/K DES/CRIPTIO/N 1 I r / <br /> Fa�7:�cuTe �cNcl ;.1�Tqll �f) oKe -(reCSh^...d�w� 3ie�.1 {`Y, II/�''nzL� e{Eu�r�ft�/ .�'esa�„r:S <br /> ca �:,�ile-�vice�� ��1�51.�.pe�e "Q�C�c�sn.ic mCy�� e�;sPlo�, a„�d resc/��x=t�/ao�e cou.�✓s +..� <br /> t c 1,� r <br /> PL MBING MECHANICAL <br /> NO. TYPE UF flXTURE OR ITEM NO. TYPE OF FDfTURE OR ITEM <br /> Toilet N d aC—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unil heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains � Other <br /> O�her <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify'hat I have read and examined this application and know the same to be true and correcl. All provisions ot laws and <br /> ordinaces governing this type of work will be complied wilh whelher specified herein or not.The granling of a permit dces not presume <br /> to give aulhority to violate or cancel the provision ot any other stale or local law regulating consiruction or the performance of <br /> construction.That I am authorized by the owner of this property to perform ihe work for which application is made and I comply with the <br /> State Coniractors Law 18.27 RC�V and 296.200 WAC. <br /> (%<����� ':%� l7 A,���l �ooa <br /> Signature Owner/ ontractor.�Aulhorized Agent D te <br /> �IZ <br />