Laserfiche WebLink
� P�RMIT APPLICATItjN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S1 REET, 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 /> =2`7o � ��C2cTT' �V�, Fva�crr 290:�,�_�a � _o & � - ao t_,05� 5- <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. G y .Z, �Ec�= A �a cifc� �-��l�� <br /> OWNER ADDRESS CITY2IP PHONE <br /> +/ c VFd'tc'�'r �� A 9�':1Gj <br /> 7����i'-r i�� . G. c. �n o 2�• 37C��<—. E!-'r`✓�<cz C�.✓�J iq i' 'f.�S ' 7 SS- <br /> 253 Ss <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> f��,v,v� t !�. A rv0 M • I <br /> E�����-H s;«�«.��C�.- �� � c��m b��- 51-JS- 3 S's- S 3-sS <br /> CONTRACTOR U �v ,�E� ADDRESS CITY2IP PHONE <br /> ,�fl �>t 4' <br /> CONTR.LICENSE# <br /> USE OF BUILDING / �- „I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �0�����(li �j. <br /> � v�v-% ,rey I Electric "�Gas Other ��, s'GU. �>� <br /> WORK DESCRIPTION <br /> `>�%T -i i <br /> � � A >Tii c N «t C=^"T� / v �'_' <br /> �� � � <br /> PLUMBING ECHANICAL <br /> IIO. TYPE OF FIXTURE OR ITEM NO. TYPE OP FIXTURE OR ITEM <br /> :'= Toilet A/C—airhandlingunits <br /> i Bathtub Forced air systems <br /> = Lavatory(wash basin) Gas piping <br /> � Shower Water heater <br /> _ Kitchen sink&disposal Gas firepiace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Clolhes dryer <br /> _ Laundry tray Range hood <br /> Sink (service/bar/mop/etc.) sZ. Exhaust fan <br /> � _ BackBow preventer Heat pump <br /> Urinal Unit haater <br /> I Dnnking Fountain Boi�er <br /> _ Floor drain REfrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> � <br /> � CITY OF EVERETT LOCAL SALES 7AX CODE IS 7105 <br /> t hereby cerilify that I have read and examined this application and know the same to be true and correct. AII provisions of laws and <br /> ordinaces goveming this type o(work will he complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel lhe provision of any other state or local law regulating construction or the performance of <br /> construction. That I am authorized by the owner of this property to perform the work for which applicatlon is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> ' l .� /�'�Ci�c--_'__ S��l �Gs` <br /> Signature of OwnedContracror/Authonzetl Agent Date <br />