Laserfiche WebLink
PtRMIT APPLICATIUN <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 !�'..�q -O � <br /> SITE ADDRESS PARCEL TAX I.D.t/ PE 7�� � <br /> ��,�a �'v�r< <� w � ��s2�� � ` � <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> � ( �'� <br /> TENANT NAME CONTACT FOR PERMIT / PHONE � o � '�SS -�S 3 7 <br /> S'TI�(I'��C�.�N I/'� L I �,/1, E-MAIL <br /> CONTRA O ADORES ��,P N / "�-CG� � <br /> �WLMOJJ bNY ��LUMB�N � r �� � �,;�(��,� � � <br /> CONTR.LICENSE p S � L M � Q �� �3 D �° �j�-`�,�i y�/c.�J <br /> 2�%O <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Eleclric _Gas_Olher l, <br /> WORK DESCRIPTION �j �L V M L�lI� � p ��—Y n ���'f <br /> 1_ , h,�;F, <br /> Cu�- �'., <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilcl A/C-air handling units <br /> Balhtub Fornd air systens <br /> 1 Lavatory(wash basin) _ Gas piping <br /> �_ Shower _ Waler heater <br /> Kitchen sink&disposal Gas Tireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Cbthes dr;er <br /> Waler healer Range hood <br />- Sink(service/bar/mop/elc.) Exhausl lan <br /> Back(low preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Relrigeration <br /> Grease trap Woodstove <br /> Rocf drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify lhat I have read and examir.ed this application and know the same lo be lrue and correcL All provisions of laws and <br /> ordinaces goveminc�lhis type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> lo give aulhority to violate or cancel Ihe provision of any other slate or local law regulating construction or the performance of <br /> conslruclion. Thal I am authorized by the owner of lhis property to periorm the work(or which application is made and I comply with the <br /> Slate Conlrectors Law 18.27 RCW and 2 .200 WAC. <br /> �-�� � �--� �J- ( 8� - D �j <br /> Signature of Ownc��[a o�I t ori;d Agent Dale <br /> / <br />