Laserfiche WebLink
PtRMIT .APPLICATI(�N <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 /> SITEADDRESS ...,__POSE�����*��� I� M/) �b6I <br /> � ' ��j L Y'7rLJl1.lJ j�SC�� � <br /> LEGA LOT NO. BLOCK TRACT OR SUPDIVISION# <br /> DESC. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> 5 5 -fo92 <br /> TENANTNAME , I CONTACTFORPERMIT PHONE <br /> ,, ,, CNLS) 3z��R� <br /> eana� <br /> i <br /> CONTR.LICENSE M U� /,�{�j/ � Ct <br /> /W�--F� <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> G�/� _Electric _Gas_Other � 0`? � <br /> ��-+ <br /> WORK DESCRIPTION � //�x / �; <br /> ��l(�c�p �XSS�TTrIb- (°n��,2-T� �o A�0 �C'-��• � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Bathtub Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink&disposai Gas fireplace <br /> _ Dishwasher Gas ranga <br /> Clothes washer I Cblhes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust tan <br /> Backflow preventer Heal pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 7105 <br /> I hereby ceriti(y thal I have read and examined lhis application and know ihe same lo be lrue and cortect. All provisions of laws and <br /> ordinaces governing lhis lype o(work will be complied with whether specified herein or not.The granling of a permit does not presume <br /> lo c�ive aulhority to violate or cancel the provision o(any other state or local law re9ulating wnslruction or the performance of <br /> conslruclion.Thal I am aulhorized by lhe owner of lhis roperty to peAorm lhe work for which application is made and I wmply with lhe <br /> Stal nlractors La 18.27 1N d 29�.200 A <br /> //2� <br /> Signature of OwnedConlraclorlAulhorized A� nl Dale �I <br /> Z <br />