Laserfiche WebLink
P�RMIT APPLICATI(�nl � <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED Fr20M 8 AM TO 4 PM ID —�S-4'7 <br /> SITE ADDRESS PARCEL Ty4X I.D.# PERMIT tF <br /> /�� � l7�.�Yi� ��o� po��-5 -oo� a� o� l' �U - v0 _ <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS C!TYIZIP PHONE <br /> �/UG�/�� .�//�!� �S'�S /`s � �°� ✓nG r E /�vf�iG'�✓ :�b-/'l/l� �b <br /> TENANT NAME CONTACT FOR PERMIT PHONE y�'6/f/f�.-s'7J2�` <br /> /'T 7/i/h�� ✓��5��G' A�r/�/� �CI� E-MAIL <br /> CON7RACTOR ��t���L/ G�,�'� ADDFESS�� `A�� ��C�TY�Z�F�R.n��PHONE <br /> •c <br /> CONTR.LICENSE# ��E'�' �� C ��� Q / <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��'1�/.�I—��� _Electric (/ Gas_Other �+��UD� v <br /> WORK DESCRIPTION <br /> ���ti'�7iL� .��%/��2aG�����i�rl <br /> PLUMBING MECHANICAL <br /> ryp, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIriTURE Jk ITEM <br /> Toilet A/C—air handling units <br /> Balhtub Forced air sysferrs <br /> Lava�ory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clolhes dryer <br /> 1Naler heater Range hood <br /> Sink(service/bar/mop/elc.) _ Exhaust(an <br /> Backflow prevenler __ Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> ' Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Olher <br /> Other _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y thal I have read and exam.ned lhis applicalion and know lhe same to be true and correct All provisions of laws and <br /> ordinaces goveming this type of work will be complied wilh whelher speci(ied herein or not.The granting uf a permit does nol presume <br /> lo give aulhority to violals or r,ancel the provision of any other state or local law regulaling conslruclion or the performance of <br /> construclion.l'hat I am aulhorized by lhe owner of lhis property to perform lhe work for which applicalion is made and i comply wilh ihe <br /> State Coniraclo/yaw 1827 CW and 296.200 WAC. <br /> . <br /> ��" -_"�. —s* �-- .— �' `'fJ' Z'7 <br /> Signa of Owner/ ontractodAuthorized Agent Date (' <br /> Z � <br />