Laserfiche WebLink
� � / <br /> PE�MIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS I PARCEL TAX I.D.N P IT X <br /> ( (008' � A� r. " <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE /l�S,� <br /> �0. ►-�c, � � �o C1 C 1^i � �" �UG"g 7 ^ `� <br /> TENANT NAME CONTACT FOR PERMIT PHON <br /> � i Y'S � L.YlO I � E-MAIL <br /> (� r�-z2 .��5= 397�1� <br /> CONTR.LICENSE# � 1��CCD7j �� � I�7//� A��/ <br /> USE OF BUILDING I HEAT SO�RCE CONTRACT PRICE OF WORK <br /> �ElecVic Gas Other <br /> WORK OESCRIPTION <br /> Zt�S�A�� Ylflc.� u � f IS�� 1� � 00 <br /> LUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FU(TURE OR ITEM <br /> � Toilo� WC—air handling units <br /> Bathtub Forced air systems <br /> _� Lavalory(wash basin) Gas piping <br /> � Shower Water heater <br /> _ Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Cbthes washer Cblhes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backtlow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined lhis application and know lhe same to be true and corcect. All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whelher specified herein or not.The granli�g of a permit does not presume <br /> to give authority to violate or cancel the provision of any other slate or local law regulating construction or the performance of <br /> construction.Thal I am authorized by the owner of this property lo perform the work for which application is made and I comply wilh the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> v ty /S' O <br /> ignature of OwnedContractodAuthorized gent Date <br />