Laserfiche WebLink
JAN-24-2005 10:07 FROMc 10::4'_5?578857 P•1 <br /> � � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR 3TREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257•8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM — DEBIT S CREDIT CARDS ARE NOT ACCEPTED <br /> SITEADDRESS O C `eSJ �'1` �3 [3 TQ,Q�OS( �JV P//MIJ"'/ I`� � , <br /> V1 <br /> LEGA lOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDNESS CITY2IP PMONE <br /> 12�5'� /I 7Zrr-�ncrL Coy3oCr� r.�sr .� �-�e� 9�za3 3.r5'3I72.. <br /> TENANTNAME C TACTFORPERMIT PHONE <br /> • I L�/L��. �.� 7r?U �� <br /> CONTRACT (n („ �� �ORESS CITY2IP PHONE �P <br /> (�/ �rn �.�.��y 2�c�.� 2���ZaZ� <br /> `�"i��"��rrcr4��o�3 � � c�x �19 <br /> USE OF BUILDING I HEAT SOURCE I CON'rFtACT PR10E OF WORK <br /> s � _Electric �Gas_Othar ��� ~ <br /> WORK DESCRIPTION <br /> ��f � �� �� �� ��� <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FI%NRE OR ITEM NO. tYPE OF FiX'TURE OR ITEM <br /> Toilet _ A/C—airhandlingunits <br /> Bathtub _, Forcedalrsys!ems <br /> Lavalory(wash basin) Gas piping <br /> Shower � Waterheater <br /> Kitchen sink 8 dlsposal _ Gas tireplace <br /> Oishwasher __ Gas range <br /> Clothes washer _ Ciothes dryer <br /> Laundry tray _ Range haod <br /> Slnk(servicelbar/mop/elc.) _ Exhauet fan <br /> Backflow preventer _ Heat pump <br /> UAnal _ Unfl heater <br /> Orinking Fountaln ,_ Boiler <br /> Fioor drafn _ RefrigeraUon <br /> Grease Vap _ Woodstove <br /> Root dralns _ Other <br /> Other — <br /> CITY OF EVERETT LOGAL SALES TAX COUE IS 7105 <br /> I here6y ceritlry thal I have read and examined this appllcatlon and know the same lo be true and wrtect. All provlslons of lews and <br /> ordinaces goveming lhis type of�wrk will be complied wilh whether specified hereln or not.The qranUng of a permit does nol presume <br /> to give authority to violale or cancal lhe provislan of any other stale or local law regulating canstrucUon or the pertormance of <br /> conslruction.That I m authorized by lhe owner ot this property to peAorm the vrorfc(or which application is made and I compiy with Ihe <br /> Stale ntractors a 1B27 RCW and 298.200 WAC. � I �� <br /> ('L <br /> S al re of wner/ nlractor/ Ibo ze Agent Dale <br />