Laserfiche WebLink
PtRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <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 '� _ �—� _ (,7 '� <br /> SITE ADDRE PARCEL TAX I.D.# PERMIT# {� <br /> ��'�'l iU�:s�` /, .-c�, I�Z ��O <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS CITY/ZIP PHONE �'1.r,j>� /�/�' <br /> (� � <br /> , .vt.��1J � t �A vi��iuc lNi ,z-L� .a7,��'� �ct-� V �c�.: 11C �V6Z���l,l,�/} ��dU �- <br /> TENANTNA I CONTACTFORPERMIT sC{,v�QII ,}P�� �vY�Sll• COM <br /> � <br /> CONTRACTOR H ` � ADDRE/SS CITY2IP PHONE <br /> � ����y �Yu/J ��' -���c <br /> CONTR.LICENSE# � � � <br /> � u�;��"� �J.d i P.�c y Y�1-�3Y� —C S�/c�� <br /> USE OF BUILDING � HEAT SOURCE CONTRACT PRICE OF WORK <br /> / / Electric �as_Olher /' <br /> �/—I"l, C'L l E — �/ ' iv v� ' <br /> WORK DESCRIPTION <br /> /�t 0�1 �l Ul.l <br /> UV\1A.� i��:+L f��� .�� �,'.�< <:.l iL � ) 7Ji� J_ i ��tic� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE Of FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> �_ Bathtub _ Forced air systems <br /> � Lavatory(wash basin) _ Gas pip:ng <br /> 1 Shower Water Coaler <br /> Kitchen sink&disposal _ Gas firepiace <br /> Dishwasher Gasrango <br /> Clothes washer Clolhes dryer <br /> Water heater Rango hood <br /> � Sink(service/bar/mop/etc.) � Exhausl fan <br /> Backflow prevenler _ Heat pump � <br /> Urinal _ Unil healer � <br /> _ Drinking Fountain _ Boiler �3 <br /> Floor drain _ Refrigerat(on � <br /> Grease lrep � ;! _ Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceritify lhat I have read and examined this application and know the same to ba true and cortecl. All provisions of taws and <br /> ordinaces governing Ihis lype of work will be complied wilh whelher specified herein or not.The granting of a permit does nol presume <br /> to give aulhority to violale or cancei the provision ot any other slate or local law regulaling conslruction or Ihe perfortnance ot <br /> conslruction.That I am authorized by tho owner o(lhis property to porform lho work tor which applicalion is made and I comply wilh the <br /> Statg,Contraclors L w 18.27 RCW and 296.200 WAC. <br /> �� —�-/� J� .v�� 0 <br /> �,4�ti � . �.. <br /> � ignalure o(O ne CoNraclorlAulhorized Agenl Date <br /> �I�L <br />