Laserfiche WebLink
PERMIT 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 0 �U�t� �yo�-c�5 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHUNE �dp _xD_' �� <br /> .� <br /> Cor�l�s ,ti�rc�zti��1oN� m9oo `��i J S� �Icv�o $ezL[.-JGI�,uLR�$� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> ���r� -KA�clk-� �flc►J ��g�er N+��c(� c{L�—`�18-3319 <br /> CONTRACTOR �� ��5����^D� ADDR'��� � CITY2IP PHONE�06�Q/����II � <br /> ��i.�A f �� �i <br /> 't�(ra Z�z D <br /> CONTR.LICENSE# 5� (�L' j�)� �i �""r <br /> l' l" �rno►JaS ,�,� 9�oZo <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �.�/�G� _Elect!ic _Gas_Other <br /> �r i <br /> WORK DESCRIPTION <br /> IVLvJfr.1G S�e.l 1L CBA2 �r`FPc� � � ISIs u� �st�� �t-b ►� �-ul <br /> litK-P�t�J t�1 �D2 T�l(�NT (I1tiPRAv 6y'Z�►.I'� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bal'ntub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplaco <br /> � Dishwasher Gas range <br /> C�olhes v:asher Clothes dn�er <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Rehigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVEREIT LOCAL SALES 7AX CODE IS J105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work wil be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authorit t violale or ca el t ovision of any olher state or local law regulating constructlon or the performance of <br /> construction I am autho ' d b owner of this property to perf rm the work for which application is made and I comply with the <br /> State Contr cto s w 18.27 W .200 WAC. <br /> - '� b <br /> Signatu r/ ontract r d Agent ate <br />