Laserfiche WebLink
--, <br /> PERM�7 APPLICATI�N <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 /> 3� APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM S�'9'•-�� <br /> SITE ADDRESS /(/( Lf�/ �a b � ��I.q y �� � P pJ�A�J��� <br /> � i�p� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDN1810N A � <br /> DESC. <br /> OWNER P.DDRESS CiiYriP PHONE <br /> 22.6 -ISb S-f S6 •- <br /> �lM �'• �oNl� ��� V NGvY�J 4wt� ' �aFs <br /> Na:r N E CONTAC7 FOR ERMIT PHONE 26 (� • (�6 ('G � <br /> /[,J�j n.iYJPrt�- ��vC� ��--�jR <br /> / '!/ � � �� 31''� ��wt� L . S 6�L�}- E�INL <br /> Z`b <br /> ^ .� �C 1�C�- <br /> e ���W. <br /> CONTR.LICENSE N 7f j I/ . <br /> USE OFBUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> 7 �v <br /> � 0�_ ����� _Electric _Gas_Other � � <br /> WORKDESCRIPTION �.��r S�;-4C�. - (S� GCGv�'�.1`7 <br /> '�_ "J„ (NL�YZ o VGw� —(o ��,�ST,�'�/��-�J3, ' . . . . � <br /> . <br /> � ?LU BIN(i , � ' � '• ME HANICAL � ' <br /> NO. TYPE OF FIXTURE OR ITEM � ��� r': -,• ' NO. TYPE OF PU(TURE OR ITEM <br /> Toilet A/C-air handlirg units ' <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) _ Gas p�ping <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(servicelbar/mop/etc.) _ E�austfan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeratlon <br /> Grease trap _ Woodslme <br /> Roof drains Other _ <br /> Other _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritiJ�that I h ve read and examin applicat—ioo a�cnow the same ro be true and correct. All provisbns of laws and <br /> ordinaces governin thi rype of work e complied with whether specified herein or not.The granGng of a permH does not presume <br /> to give authority to i t ol ca�fe provision of any other state or local law regulating constructlon or the perfortnance of <br /> con�truction.T th ' ed by lhe owner of this property to pe orm the work for which applicaGon is made and I comply with the <br /> State Contra ors . 7 W and 296200 WAC. <br /> ,��� �, 6 � <br /> Signature of ContractodA ihorized Agent Date <br /> a <br />