Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 47.5-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �15 � � �av�-� od-t 90 -� cx� M ��0 9- ,�. <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> �1�a��,, o� � �06 �, �-r��~tt �4RI� l�,�n��r� Lin � �����r1-lq���� �?5 2�1-3118 <br /> TENANT NAME CONTACT FOR PEP.MIT PHONE <br /> I ��L�� <br /> CONTRACTOR����Y�y �L rc\\� .a�S. ��RESS(�'j��� �Q�1eV CITYZP PHONE <br /> U , -�nQ, S(1X�G� � a��I� ZO�P- <br /> CONTR.LICENSE�,n�,���9�n S ��I I� -i25 ��jS <br /> 1� �l �-� <br /> USE OF BU�LDING HEAT SOURCE � CONTRACT PRICE OF WORK <br /> _Electric _Gas�Othe�( � l�p� <br /> WORK OESCRIPTION � <br /> C9-�- C- �� c`�� � r-�-tiv�a�. C. 1'r�o.-+��Gu� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toiiel A/C-air handling units <br /> Bathtub � Forced air systems- o�1 <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(servicelbar/mop/etc.) Exhaust fan <br /> Backflow preventer Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> F�oor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains ��e� <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS]106 <br /> I hereby ceritify that 1 have read and examined this application and know the same to be true and cortect. All provisions of laws and <br /> ordinaces goveming this type of work will be compiied with whether specified herein or not.The granting of a pertnit dces not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construdion or the performance of <br /> conslruclion.That I am authorized by the owner of this property to peAortn the work for which applicatian is made and I comply wilh the <br /> I St te Contredors Law 1827 RCW and 296.2 O WAC. <br /> � '�I�,I.�C L�.Ck,`--l'V1 •�'X �l'��1� <br /> Signat— u�Owned ont2cro Authonzed Agent Date <br />