Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> • 425-257-8810-FAX 425-257-885i�-www.everettwa.org <br /> APPLICATIONS.4RE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> I1�(oa E�c-v�,,e�� w.a�� ocy�/29ooYo/800 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. C F�a�a� <br /> OWNER ADDRESS CITY2IP PHONE <br /> W°.�Ma�--r �RcS,�'-uc.. yoo ( gc IoT'�ST. �'r°^�`LA'cci�4127�//6 �`f?��'�2r6� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> GU,4��✓La�-r ^rc?Sp .�'R�W2-Y �So3� 90'7-0070 <br /> CONTRACTORG�-= l'1'�2l �,tF �wA6° E�pF �ICW� �ST�IA P�iZTH1.b.N�J �c�9?1?n <br /> CONTR.LICENSEM GSS�G�-Ca�L� C�03>�{07 -0070 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S��'M ���'� _Eledric _Gas_Other �� � L�0 O t� <br /> WORK DESCRIPTION <br /> ?Z � xZ�' kl0 ` S'roR.r�wdZt� l�T�c'�-a+�t t!-4utT' <br /> PLUMBING MECHANICAL <br /> NO, TypE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet AIC–airhandlingunits <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> ._ Shower Water heater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> ,_ Dishwasher Gas ronge <br /> ._ Clothes washer Clothes dryer <br /> _ Laundry irey Range hood <br /> _ Sink(service/barlmop/etc.) Exhaust fan <br /> _ BackOowpreventer Heatpump <br /> ._ Urinal Unit healer <br /> _ Drinkina Fountain Boiier <br /> _ Floordrain Refrigeretion <br /> _ Grease trap Woodstove <br /> _ Rcof drains Other_ <br /> _ Other — <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3705 <br /> I hereby ceritify that I have read and examined this application and know ihe same to 6e true and correct. All provisions o�laws and <br /> ordinaces governing this h r 'work will be complied with whether specifled herein or not.The granting of a permit does not presume <br /> lo give authority to violate� _.� - �I the provision of any other state or local law regulating construction or the pertormance of <br /> construdion.That I am aut��o:�zed by the owr.er c!thit property to pedorm lhe work for which appliwtion is made and I comply with the <br /> Stale a4reeterg Law 27 ;,u 296.200 WAC. <br /> � 2���� <br /> Si9��� l5wnedContr/ctorh4di�n d Agent Date <br />