Laserfiche WebLink
PCRIWIIT APPLICATIC�N <br /> CITY OF EVEF'.ETT PERMIT SERVICES <br /> 3200 CEDAR ... REET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org <br /> .�pl�-1 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADD ESS PARCEL TAX I.D.# PERMIT# <br /> Zr 2 Go(��.b►ti ��e �soo2 or3oa �.�OS'ZG� <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION p <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> �ct�'T� li C a v r 21 b2 Go�d.x�i�� /`�Z <br /> TENANT NAME CONTACT FOR PERMIT PHONE(c�ZS� T���24�� <br /> �Rv���"e( C�V �Sa�cc ��IJM E.MAIL <br /> G�NT A TOR�' AODRESS ITYIZIP P <br /> 1s�� � /�II�-� ��z� �-i{``��� ,M��ys�;ll� �zs vy�� 2�� <br /> CONTR.LICENSE# <br /> An1 GTG� 933M� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �R YC[G�P / �J(p�Lt�(� _�leclric _Gas_Olher 32 004 <br /> � <br /> WORK DE CRI TION <br /> �� �/ /1'�O �9CIS��t \�t�l/� c��,� <br /> d � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handliog units <br /> Balhtub Forced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasranc�e <br /> Clolhes washer Clolhes dryer <br /> Waler heater Range hood <br /> Sink(service/bar/mop/elcJ Exhausl(an <br /> BackOow preventer Heal pump <br /> Urinai Unit heater <br /> Drinking Fountain _ Boiier <br /> Floor drain Refrigeralion <br /> Grease Irap Woodslove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y Ihal I have read and examined Ihis application and know Ihe same lo be lrue and correcL All provisions o(laws and <br /> ordinaces governing this type o(work�vill be complied�vilh whelher specified herein or not Tho granting of a permit does not presume <br /> lo give aulhority to violale or cancel lhe provision o(any olher slato or local law regulaling consWclion or Ihe performance of <br /> construclion.Tha�I am aulhorized by the owcer of lhis property lo pertorm lhe work(or which applicalion is made and I comply with the <br /> Slale Co clors Law 18.27 RCVy and 29G.200 WAC. <br /> �l��i_ /4 �1 y iy-�' <br /> Sign lure of Owne, nlractodAulhonzed A9ent Dale <br />