Laserfiche WebLink
�E.�MIT APPLICATIO�� <br /> CITY OF EVERETT PERMIT SERVICES � �� Z �d <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ( � <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> ��� yJl- oo� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PF�RMIT� <br /> / D �o � %-1cll Q '� � Gb,S 2� C.'03 OU;(' -- <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. � <br /> I � /2�.-.� ��, 1n�iorc � cr <br /> OWNER ADDRESS CITYIZIP PHONE I <br /> J; m l� ra � I ���� / �w'�' /7lii= Ir�✓ ���>��u.�x��` /,cJ� �l25 7�2-�t.�<5 <br /> TENANT NAME� CONTACT FOR PERMIT PHONE <br /> S� ,n l�� ��r � �25 �'7 <br /> CONTRACTOR A�DRESS CITY2IP PHONE <br /> CONTR.LICENSE X '/ / \ <br /> �w �-�`'L--� � CO�C �C �nei;J (�l i4 ti:,�-- 1 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��� I _Electnc �Gas_Olher <br /> WORK DESCRIPTION '� <br /> ��� I:�Y" ` � � (-.� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> .� Toilet A/C—air handling units <br /> ! Bathtub = Forced air systems <br /> � ' Lavatory(wash basin) � Gas piping <br /> � Shower i Water heater <br /> � Kitchen sink 8 disposal �_ Gas fireplace <br /> / Oishwasher Gasrange <br /> � Clothes washer � Ctothes dryer <br /> Laundrytrey � Rangehood <br /> Sink(service/barlmopletc.) '-� Exhaust fan <br /> BackFlow preventer Heatpump <br /> Unnal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain I _ Refrigeration <br /> � Grease trap Woodsrove <br /> I Roof dreins Other <br /> I Other <br /> � — —I <br /> �. CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby ceritify that I have read and examined this application and kno�v the same to be true and correct. All provisions of laws and �� <br /> ordinaces governing this rype of work will he camplied with�vhether specified herein or not.The granting of a permit does not presume � <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of i <br /> construction.That I am authorized hy the owner of this property to perform the work for which application is made and I comply with the � <br /> State Contrac;ors Law 18.27 C'N and 296.200 WAC. � <br /> / � <br /> L— ,-r,,, (�/,'/. `• /� / Z �� ! <br /> Signamr CwnenContracrorrA onzed Agent 0 te � <br />