Laserfiche WebLink
, <br /> ; <br /> �RMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �. a6 .a7 <br /> I <br /> S�TE ADDR��_� ruM Wa PARCEL TAX I.D.N P�R��� _ �3 ', <br /> YI <br /> i <br /> LEGA LOTN0. BLOCK TRACT 1 <br /> DESC. f <br /> OWNER ADDRESS CITY2IP PHONE <br /> / <br /> TENANT NAMi �/�`��,,, ,J � CONTACT FOR PERMIT PHONE <br /> �� � � ����� T� a�G-6�� /y�y <br /> �� , <br /> CONTRA TOR AD RESS CITYlZ�o PHONE ��'^� _b, 7 <br /> G'Cve,�l` s✓� C�,�P • ��y 5. Gw�� 5f- $r�.��95�13 I a.. <br /> CONTR.UCENSE# Ll RC�fTS� 9�1D�- <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> EleclricX.Gas_Olher `,� �� a`�� <br /> WORKDESCRIPTION ��St� � ( Q� ��p,� L Gi/tr,tS� Na�r'l �� ��`�tiS7 <br /> �-�, o�. �t�. �� vp ,�„� v�, ��� , � � �� �1 D��t wb�k _ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FfXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handting units <br /> Bathtub �_ Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> Shower _ Waterheater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer Clothes dryer <br /> Water heater �, Range hood <br /> Sink(servicelbar/mop/etc.) � Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountair, _ Boiler <br /> Floor drain _ Re(rige2tion <br /> Grease trap _ Woodstove <br /> Roof drains _ Other <br /> Other — <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify tha!I have read and examined this appiication and know the same to be true and cortect. All provisions of laws and <br /> ordinaces governing lhis type of work will be complied with whether specified herein or not.The granting of a pertnit does not presume <br /> to qive authority to violate or cancel the provision of any other stata or Iocai law regulatlng construcBon or lhe pertormance of <br /> construction.ThaUam�uthor' ed by the owner of this property to peAorm the work for which application is made and I comply with the <br /> Stale Co ors Law 1 _2Yfl�W and 296.200 WAC. <br /> �;�%�� //r/v � <br /> Signatu of Owner/ContractorlAuthonzed Agenl Date �� <br /> Z <br />