Laserfiche WebLink
P�RMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 320U 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 5—S '� <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT M <br /> �o�r �w/� �t r�a�os-oo� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> /1 I G1�r'N S(�Or� ���S �u/�i�/�- LCv�r� �gZO'� yz�Z sz 7 38 <br /> TENANTNAME I CONTACTFORPERMR PHONE <br /> E-MAIL <br /> �dN�uce se a 4�1 �F'SPr✓ .T�a c ,?�O�.F�/<f�.�5'�.� 9�'LO � �!z ZS9- 2/C� <br /> Ey� .�i�/55o�fzkZ <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> r <br /> /�� G �Electric _Gas_Olher Z�fDO' <br /> � <br /> WORK DESCRIPTION <br /> /1 P�11O�/L q�",�'t�D�Ge ��PL7�/ � �i.�n P�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR�TFM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathtub 2 Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(senice/bar/mopletc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Flocr drain RefrigereUon <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceritify lhat� have read and examined lhis 2pplicalion and know lhe same to be We and correct. Ail provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specified herein or not.The granting of a pertnit does nol presume <br /> lo c�ive aulhority to vioiale or cancel the provision of any other slale or local law regulaling wnstruction or the periormance of <br /> construction.That I am authorized by the owner of this property lo perform the work tor which application is made and I comply with the <br /> Stale Conlra ors Law 27�RCW, and 296.200 WAC. <br /> G��-�P����fZ'�' S "�" �� <br /> Signat re of Owner/Conlraclor/Authorized Agenl Date <br />