Laserfiche WebLink
PtRMIT qPPLICATIC�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everetlwa.org 7�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITf! <br /> � r7o,eE � Oa7�386o���3t(� a�o5 - ��� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> �G��� _ /7// �OGErnodc� nl ��aa�_�IZ5 3�/8 3�1�� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> I $��r,a-►� �2��� �lzs-�s-Gs��y. <br /> CONTRACTOR p E-MAIL <br /> I / I <br /> DAY�-�/i� Ptma;;- �-NT�- ��6/y l.�.q�_ <br /> CONTR.LICENSE# -W. L 4'�✓r/�"-� y�5,775_��� <br /> �i4�/n�.=PH��/U�C'c.;� 9�3� <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> I _Eieciric �Gas_Other �� �, � <br /> WORK DESCI2IPTION � /�� <br /> ��P/�9CE �X/5T7n/� V f�'S %r�/�l✓/}C� !.1/1Tff /�c.�afiC� <br /> �r/15 �Ll��/A�E �� S�►'�� [.GC'FIT7� - <br /> PLUMBING MECHANICAL <br /> NO. iYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> — Ba������� A/C–air handling units <br /> _ Lavatory(wash basin) � Forced air systerns <br /> Shower _ Gas pipinc� <br /> Kitchen sink 8 disposal _ Water heater <br /> Dishwasher _ Gas(ireplace <br /> Clolhes washer _ Gas range <br /> Waler heater _ Clothes dryer <br /> Sink(service/badmopletc.) ._ Range hood <br /> _ Backflow preventer _ Exhaustfan <br /> Heat um <br /> Drinking Fountain _ Unit healeP <br /> Floor drain _ Boiler <br /> Grease Irap _ Refrigeralion <br /> Roof drains _ Woodstove <br /> Oiher _ Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />' 1 hereby cerilify Ihat I have read and examined ihis application and know lhe same to be true and correcl. All provisions ol Iaws and <br /> ordinaces yoveminc�Ihis type ot H�ork will be complied with whether specified herein or not.The granting of a permit does not presume <br /> lo give aulhoriry lo violate or cancel the provision o(any olher state or local law rec�ulating consWction or lhe performance o( <br /> conslruclion. Thal I am aulhorized by ihe owner of this property lo pedorm the work for which application is made and I comply with the <br /> Stale C nlrr lors La�v 1 . CW d 296.200 WAC. <br /> ` �� —� <br /> S�9 wner/Conlra r/Au ioriz � Dale <br />� <br />