Laserfiche WebLink
i <br /> PERMIT APPLiCaTION <br /> CITY OF EVERETT PEF,'MIT SERVICES <br /> 3200 CEDAR STREET, EVE.NETT, WA 98201 <br /> 425-257-8810-FAX 425-257•8857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEP'�ED FROM 8 AM TO 4 PM 6 -1 S-� <br /> SITE ADDRE:.S PARCEL Tp X I.D.# PERMcR��1 - <br /> �. �l.h� �T �9043(�Cb4b3-o0 I .��� I "J ��� 7 <br /> LEGA LOT'VO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER AD�RESS CITY2IP PHONE <br /> �'f� t��21ENE L�� tTHERS 3�1 u�c�r�I �rvDD�Z C.� lA ) A �as3o� q6�y <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Nliq�-�6tUC- �7 HG- E�NIAILNq21c �c c� C�2 <br /> A c.._�/t�R i 2e h ./J <br /> CONTfI.LICENSE M %��,�Y��r <br /> USE OF BUILDING I ' HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Rss� oEn,�- <br /> Eleclric _Gas Other <br /> WORK DESCRIPTION <br /> App � X �� �OD ���ON -Co ExIST �N � HO�S6TG En�iHRGE F3EORo�M <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet FVC-air handling units <br /> Bathtub Forced air systems <br /> lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas iireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/elc.) Exhaust fan <br /> Bachflow prevonter Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVEHETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritily that I havc!read and examined this applicalion and know the same to be true and correct. Ali provisions of laws and <br /> ordinaces governing this rype of work will be complied with wheiher specified herein or not.The granting ol a permit does nol presume <br /> to give authoriry to violate or cancel the provision of any other state or local law regulating construclion or the performance of <br /> construction.That I am aulhorized by the owner of this property lo perform the work for which application is made and I comply with the <br /> State Contraclors Law 18.27 RCW and 296.200 WAC. <br /> �"�p� Cn,v.s; 1 �'� -t � \, ^ o�<O _ � -I <br /> ..�.t� <br /> Signature of OwnedC.ontractoAAuthonzed Agenl Date i�,Z <br />