Laserfiche WebLink
PtRMIT APPLICATIC�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 f 2 �-��} �6 S <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �LI� Cr.�sccN; A�� �5 r-f 9 9 170'�I Z -UC�`-� <br /> LEGAL LOT NO. BLOCK TRACT <br /> oesa � j4 r�i/ �icwc,� I-�isibnrs <br /> OWNER ADDRESS CITY2IP PHONE <br /> j�DDN . !-I-� P�'� gcX Z�'77 EvE�f( W/t a�7.�i3 C�251.3qF-4ri54 _ <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> N�A 1�� Nu�so� (4zs)soy-�9s� <br /> CONTRACTOR -�' u�- ���`��KY ADORE55 CITY2IP PHONE <br /> 4'731 �e5r rRert KP - (3Gc)L-J� - c7LL <br /> CONTR.LICENSE# _'���GT � CfOL3 �ili�vJha�x, �qJA q�izLti <br /> USE OF BUILDING HEAT SOURCE CO�TR T PRICE OF WORK <br /> � � �' Eieclric Gas_Otner r 0 �OL' <br /> S�r�G� rrn.�iW — � <br /> WORK DESCRIPTION <br /> 1k��io l��h�" oF EX�sn��> Nt�l,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> I Toilel A/C—air handling uNts <br /> I Bathtub Forced air systems <br /> Lavatory(wash basin) Gas oiping <br /> Shower � Water healer <br /> J_ Kilchen sink R disposal � Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Cblhes dryer <br /> 1Naler heater _f_ Ranc�e hood <br /> Sink(service/har/mop/etc.) _ Exhausl(an <br /> Backllow prevenler _ Heat pump <br /> Urinal Unil heater <br /> Drinking Fuunlain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease Uap _ Woodstove <br /> Roo(drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify lhal I have read and examined this application and know lhe same to be lrue and correcL AII provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specified herein or not.The granlinc�of a permil does nol presume <br /> to give aulhority to violate or cancel the provision ot any olher slate or local law rec�u�aling consWction or lhe pedormance of <br /> construction.That I am authorized by lhe owner o(this property to perform the�vork for which applicalion is made and I comply wilh lhe <br /> State C3r�lraclot4 La i 18.27 RCW and296.200 WAC. <br /> � <br /> `�' %� /T`j � ��-- �^7 Z7 L�S <br /> SiqLn�lure o O r%Cont�dAuthorized Agent Date <br />