Laserfiche WebLink
� <br /> PEt�MIT APPLICATION <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 c� `/(( �p 7 <br /> SITE ADDRESS PARCEL TAX I.D.il P RMI � <br /> ��ci� DG-,-/;. y�ti �iv' o - a- I <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> .�j � J A� y ��L�� 3S 3 <br /> n�Iyl'/, t' °� � L�.�c; .;,, ,�� fi `�c�� a„-/;�T� „ / iV r_"I%�UG%���rl��J �r`�3J <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> ;'.:, f t�l � ��i��/ �FZ3"- � ��' �7Z � <br /> CONTRACTOR , ADDRESS CITY2IP `fj PHONE <br /> �i//!!�L� J�' �f �S�� � ./G G� I ,� �' ° ✓71������ . ; G'Y.!/ y Z S 'Z 7 �� z-IC <br /> CONTR.LICENSE# ����� � <br /> � ;�,9N'SS n���z /�L <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> /" �f ) L'O -. <br /> `� �-j yEleclric _Gas_Olher <br /> / — <br /> WORK DESC�tIPTION /f L t�^,�� _j'��r �r�, � i -z� �5 �i �� j��. '� ?c:••J�.� <br /> �/� f n�c,C�'t '�' � /` / ' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet � A/C-air handlinc�unils <br /> Balhtu� For�ed air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kilchen sink&disposal _ Gas firepiace <br /> Disliwasher Gas range <br /> Cblhes washer Clolhes dryer <br /> Waler heater Ranc�e hood <br /> Sink(serviccibar/mop/etc.) Exhaust fan <br /> Backflow preventer � Heat pump <br /> Urinai Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease lrap _ Woodstove <br /> Roof drains Olher <br /> Olhcr <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby cerili(y that 1 have reaA and examined this applicalion and know the same to bo lruo and correct. All provisions of laws and <br /> ordinaces governing lhis type of work will be complied wilh whether specified harein or nol Tho granting of a pertnit does not prosume <br /> to give aulhoriry lo violalo or cancel lhe provision of any other stale or local law regulating consWction or Ihe performance of <br /> wnstruction.That I am authorized by tho owner of this property to perform Iho work for which application is made and I comply with the <br /> Slale Conlractors.Law 18.2Z RCW and 296.200 WAC. <br /> � �} <br /> r'v , -��/-t� .. <br /> :�,% � -�'� � � <br /> Signature of OwnedConUacmr/Authorized Agenl Date <br />