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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />1�1o. <br />PARCEL TAX I.D. # <br />PE MIT # <br />03-CAS <br />LEGAL LOTNO. BLOCK ACT <br />DESC. <br />OWNER ADDRESS CITY2IP PHONE -4- <br />Nbhoc)is�r��. <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />CONTRAC OR �r�� V. O \ ADDRESS CITYIZ�IP P N <br />\.OV 9aks`�s.abs�, lO7 lShZ/o- <br />Con <br />Ux <br />pyoaO <br />CONTR. LICENSE #i ca:�)T(y�� <br />\J <br />USE OF BUILDING HEAT SOURCE CONTRACT PP�RICE OF WORK <br />Electric —Gas —Other <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_, <br />A/C —air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />_ <br />Gas fireplace <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />_ <br />Range hood <br />_ <br />Sink(service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heatpump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boiler <br />_ <br />Floordrain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Wcodstove <br />_ <br />_ <br />Roof drains <br />_ <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />1 hereby centdy that I have read and examined this application and know the same to be true and correct All provisions of laws and <br />ordinaces 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 perfonnan� of <br />construction. That I am autharized by the owner of this propert, to perform the work for which application is made and I comply with the <br />tal Contactors Law 18 - RC� .200 WAC. <br />S) <br />-� <br />-z-o7 <br />S gnature of Owner/ ontractor/Authonze Agent Date <br />M <br />101 <br />