Laserfiche WebLink
PtRMIT APPLICATICiN <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 <br /> SITE ADDRESS ' Z E/j_� 5. r PARCEI TAX I.D.# PERMIT# <br /> ta <br /> � - yg X�- �� <br /> LEGAL LOTNO. BLOCK TRACT <br /> Desc•1 <br /> OWNER ADDRE55 CITY2IP PHONE <br /> u4-1 �� - z��ir'r+ � 2tiy-25� F'7 ..Sr �iu�oj� � ns�� z 1��,+—�-4) �Gc I4Z1 <br /> TENANT NAME/ CONTACT FOR PERMIT PHn E <br /> ', l�i� !' � 1 %r1�,t't H hicd AL ir� v�i,.�l. <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE# (,, 1� \ \�e n <br /> ��YV <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> �/Electric Gas_Other <br /> WORK DESCRIPTION <br /> i� ��_ �: �.J1ic�rr�c� i��� � 0✓'�2i� <br /> u <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C—air handling unils <br /> Balhlub Forced air systeins <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> = Clothes washer � Cbthes dryer <br /> Water healer Range hood <br /> Sink(service/badmop/etc.) _ Exhausl fan <br /> BackOow prevenler _ Heal pump <br /> Urinel Unil healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigaralion <br /> Grease trap _ Woodslove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> i hereby ceriti(y lhat I have read and examined this application and know the same to be lrue and correcl. All provisions of laws and <br /> ordinaces goveming lhis lype of work will be complied H�ith whelher specified herein or nol Tho granting o(a permil does nol presume <br /> lo give aulhonty lo violale or cancel Ihe provision o(any olher slale or local law regulaling consWclion or lhe performance of <br /> conslruclion.Thal�l am authorized by the owner of lhis property to par(orm the work for which application is made and I comply wilh the <br /> State Coniraclors Law 18.27 RCW and 296.200 WAC. <br /> i': y; /,� ' ° � <br /> Signature 'OwnedContraclor/Authonzed Ac�ent Dale <br />