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 /> �l(��� APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM . 2 <br /> SITE ADDRESS PARCEL�T1AX I/.D.# r ^ '1 RM <br /> 3 `I Ev2rL �� 'L l7� S ) �J lil � UV / V� tj' _„� <br /> LE LOT NO. BLOCK TRACT OR SUBDIVISION# . <br /> DESC. � � (/?1� � <br /> OWNER ADDRESS, CITYIZIP PHONE y�f,Zs�, ,��Q <br /> S h � � �2 as; �c� �-l—< S 013 GI a �� m c ,.+ E v��^t'F) (.�//� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> N/� ��M �I��Qi �LSEMa� 44�5 ��N/� S�J�;(d <br /> �. <br /> ON RA R � DDRE I I IP <br /> �� R�o� s <br /> CONTR.LICENSE M <br /> USE OFBUILDING G ��u.,� HEAT S/O,URCE CONTRACT PRICE OFINORK <br /> _Eleclric � ' Gas_Omer ! � f�� L�U D <br /> WORK DESCRIPTION � '7�N/1� � �►'1P/�Als�` � <br /> � � , <br /> k rV/� 7 �ILG7 /Lc.l:U�nJ �e1LltiV S _� �� I..u,1 <br /> I <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Z Toilel ( AIC-air handlin�units <br /> Bathtub � Forced air systems <br /> �- Lavalory(wash basin) I 1 Gas piping <br /> Shower �_ Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Water healer Range hood <br /> Sink(service/bar/mop/elc.) Exhaust(an <br /> Backflow prevenler _ Heal pump <br /> Urinal Unil heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ 1Noodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritity thal I have read and examined lhis 2ppiication and know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming Ihis type of work will be complied with whether specified herein or not.The granling of a permit does not presume <br /> lo give authority lo violale or cancel t provision of any other stale or local law regulaling consWction or the performance of <br /> construclion.That I am a rtzed t e o (this property to pedorm the work(or which applicalion is made and I comply with the I <br /> Stale Conlraclor a 1 .27 RC a 6.20 AC. ) '/ � <br /> 7rJ'� `�v <br /> Signature ot OwnedContraclod onze gent Dale � /� <br /> � � <br />