Laserfiche WebLink
PERMIT APPLICATIGN <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 - DEF31T & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS I PAR EL TAX I.D. # PERMIT # <br />p1; iaLuiti �1> os)� oogoYs oo Boc�cy�-v� <br />LEGAL LOT NO. BLOCK TRACT <br />OW14ER ADDRESS CITY/ZIP PHONE <br />`c ao- <br />Go ' F " 14 zo Z 1� �eN-sc�ale dam.+ 207- $-95Jite A� 5 s zsL <br />f Cam, I/ I &Q7— 7T4 I <br />_ <br />TENANT NPERMIT <br />AME <br />CONTACT PHONE <br />c <br />J <br />/ <br />I S0tAt ff l lr (-b6 qa- 0 0-6706 —I V 1 <br />L <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />PRICE OF WORK <br />-- Electric Gas Other <br />I QFONTRACT <br />T,' <br />WORK DESCR ' TION <br />jztoki v`(- ujv-" g-S SDI d-W'K I PeLft., ot0 its ct u.J f Y lOCiz IG <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />_ <br />A/C — airhandlingunits <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />_ <br />Dis;,washer <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/barlmop/etc) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit hPaler <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />_ <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the 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 application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />n1. 6-� o� <br />Signature of Owner/Con? c r uthorized Agent Date <br />