Laserfiche WebLink
P�t2MIT APPLICATIO�N <br /> CITY OF EVERETT PERMIT SERVICES , <br /> 3200 CEDAR STREET, FVERETf, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everet'wa.or� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM v ��lv <br /> SITE AqD�DRESS PARCEL TAX I.D.# PERMIT i� <br /> �(��C•� f l� +C��i7 ��CG� _ 5�(XJI.Q �� <br /> LEGAL LOT N . BLOCK TRACT OR SUBDIVISION# <br /> DFSC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> TEN T NAME I CONTACT FOR PERMIT PHON[ �� ��l�_�3$g' <br /> �� ,�e j � <br /> • �GUCZ//" !o rv �Y G���-� I �ti`�Y � e-Ma� Q��E�.cen, <br /> R s� ,V E�---Z`IT�Z P <br /> t��n�c � Ro�e�c 3�,�-2 h�2,e�'� r,�„t- 9�0&3 94�9�� <br /> CONTR.LICENSE# �CD�/,� �3�Q� �, `�j/ — <br /> /T P� <br /> USE OF BUILDING HEAY.'iOURCE CONTRACT PRICE J: WORK <br /> Electric Gas Olher �'o��Q.�v <br /> WORK DESCRIPTION <br /> .�i✓s�ic o.�r sr," o-� c�ti��� L �E ii� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C—air handling unils <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> K4chen sink&disposal _ Gas firaplace <br /> Di,hwasher Gas range <br /> Clothes washer Clolhes dryer <br /> Wa:er heater Range hood <br /> Sink(service/badmop/etc.) Exhaust fan <br /> BackOow prevenler Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> Floor drain Re(rigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify lhat I have read and examined this application ard know the same to be lrue and correct. All provisions of laws and <br /> ordinaces goveminy this lype of work will be complied with whelher specified herein or nol.The granting oi a permit does nol presume <br /> to give authority to violale or cancel the provision of any other state or local law regulating construc6on or the performance of <br /> construclion.Thal I am authorized by Ihe owner of lt�is oroperty to pertorm the work for which application is made and I comply wilh lhe <br /> State Co lraclors Law 18.27 RCW and 296.200 WAC. <br /> � a(��v�Z� <br /> Signalure o(O nw e�/ContractorlAuthorized Agent ate <br /> � ��2 <br />