Laserfiche WebLink
I--- - -- --- --- � � <br /> ----- --- - - - ----- -1 <br /> PERMIT APPLiCATlO�J � ��c�i;��t� <br /> II CITY OF EVEI�ETT PEhMIT SERViCES - -�°`� <br /> r,i,r,r• > <br /> I 3200 CEDAR STf:EET, EVERETT, VJA98201 I <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM'i 0 4 PM <br /> II SITE ADDRESS PARCEL TAR I.D.# P RJN �Il�/ / <br /> i '��/U `-�('"� �vc��� /v��� �a. � <� S� �fOU3���� � Cl� C-� /(�i <br /> � LEGAL LOT NO. BLOCK TRACT <br /> DESC. — � /,�L <br /> OWNER ADDRESS CITY/ZIP PHnNE <br /> !a_/oy <br /> I �y��-�-�V1�I1 aFE��e ��ds ��� ioi�r.s td M.,ilSurv lu.e-c�- ��•;r <br /> I TENANT NAME CONTACT FOR PERMIT PHONE <br /> �ivic✓s 1v.su�ti..,�-� '�r..:•-�� /V1��.�� �izs t�,o� - �I3 7Z <br /> CONTRAC�OR ADDRESS CI7YIZIP PHONE � <br /> .M.,.% /Ylac.�.o.-Jc a� �'��' 9L 30 /y3''.14�.e �-CC: Zw�+-u..c� +'1 ZJ'-`O£fi. �5 z y� <br /> CONTfi.LICENSE# <br /> _�il.�4 i T/��L �In 3G�'� 'I�tiSZ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �..,�/�/�i �" <br /> �.Jl-Y G� _Eledn�Gas_Olher �.i�i��� <br /> ' VJORR DESCRIPTIUN �e O�� L ` � <br /> I ��1occ_ 1C�6/ rr� �ii!! l'i�1 �-1.�5 � � ) <br /> iCln� 1��W �POi.'�,Y��'Y�VSL ��� INGI'¢,�' I-J:,cLG�, ��CJ. L, I <br /> I PLUMBING MECHANICpL I <br /> �. NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> �'I _ Toilet ArC—airhandlingunits <br /> _ Balhtub Forced air systems <br /> , _ Lavatory(wach b3sin) Gas piping <br /> ; Shower Z Water heater ; �j St���, <br /> I � Kitchen sink 8 di,posal _ Gas fireplace <br /> I _ Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> �� Laundry tray Range hood <br /> '� Sink(service/badmnp/etc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> �, Urinal Unit heater <br /> � _ Drinking Founlain _ Boiler <br /> I�, _ Floordrain Refrigeration <br /> I _ Grease trap Woodstove <br /> �I _ Roof drains _ Other <br /> I _ Other_ _ I <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby centify that I have read and examined this application and know lhe same lo be irue and wrrect. All provisions of laws and <br /> ordinaces gu�eming this type of work will be complied with whelher specified herein or not.The granting of a pemiit does not presume <br /> i to give authority to violate or cancel the provision of any other state or local law regulating constmction or the performance nf <br /> . conslruction.That I am authorized by the owner of ihis property to pedorm the work for which application is made and I comply wilh the <br /> '��. State Contrar,tors Law 1827 RCV/,/�a d 296.200 WAC. <br /> �_`?�.._� /f ���c c � r/��i�_���[.��C� <br /> �� Signature of OwneNContractor/ ,:f orize Agent Dat� <br />