Laserfiche WebLink
/ <br /> P�RMIT APPLICATIClN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org 1 `�'�� <br /> APPLIGATION:: ARE ACCEPTEU FROM 6 AM TO 4 PM P 7D� " G�� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT N <br /> ./k 32 -�v�2G2�rti cu� � -b 31 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> t�.��oe-�- R�`��� �c.r <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> 9�ti�-r �a�r�,` ��� f�o� �P�,�v,� a o 6 ��-'� ��'�/ <br /> CONTRACTOR . ADDRESS �,r �Gr rCITY/ZIP PHONE � <br /> 7C?AL h��>!'t(I/1.'6 3�v 4�-i06 �f / �. d=�ztn r�ut��3� <br /> CONTR.LICENSE# � ��� v� <br /> ToT�tL��o�9 p�_ _ <br /> USE OF BUILDING I — HEAT SOUR�.E CONTRACT PRICE OF WORi: <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> �UM (� i,v6 f v�- � ia2i y., ' �s► <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilat A/C—alr handling units <br /> Bathtub Forced aIr;ystems <br /> � Lavatory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> � Kitchen sink 8 disposal _ Gas fireplace <br /> � Dishwasher Gas range <br /> Cbthes washer Clolhes drye� <br /> � Waler heater Range hood <br /> �_ Sink(service/badmop/etc.) _ Exhaust fan <br /> 1_ Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> � Grease trap _ Woodstove <br /> Roof drains , . _ Other <br /> 'S Other L i>i.ccc]-2.u1 in.S _ <br /> �Gc�-t, 5'�n.ft f _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify lhat I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing lh:s type of work will be complied with whether specified herein or not.The granting of a pertnit does not presumo <br /> to give authorily to violate or cancel the provision of any other state or local law regulating construcUon or the perfortnance of <br /> construction.That I am authorized by the owner ot this property to perform the work for which application is made and I comply with the <br /> State Conlrppplor w 18.27 RCW 296200 WAC. <br /> Ul I- �-o �- <br /> Signa— lu�Own ontrectodAuthonzed Agent Date <br />