Laserfiche WebLink
( <br /> PERIVIIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETI', WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM a � � j— C7� <br /> SITE A�DRESS PARCEL TAX I.D.# PERMIT# <br /> 1401 I�MeartD /�VE OO'(-5062HSOOZOp �b�UZ-vOS <br /> LEGAL LOTNO. BLOCK TRACT <br /> oesc. 1,tNe.i615�2 �.8g <br /> OWNER ADDRE55 CITYIZIP PHONE <br /> �DANiE�. �ousc..4ss 1401 I..or,e,��.o a�vE t�g?�-�-r- 425.931.�'f47 <br /> TEHANTNAME CONTACTFORPERMIT PHONE <br /> � OwNER <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> �VlNER <br /> CONTR.LICENSE p <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> NoNE <br /> C.7AR/vGE I _Electric _Gas_Other .', I ,3 I Z <br /> WORK DESCRIPTION <br /> NQW 6ARPbE CONSTR�1CT10U . Zu�X2/} GAR/�fiE S� FROM �'M PRoPERT�( LI�1E , RE,V�gW 2 <br /> fRG2e5g qppRO�ED ZD�MhKINUM NE16HT. :'�14 CI.EF.TRKAL SHRVIGE� WATER�TE�PHoN6�CAgl.E'�CAT�S� <br /> �oe�El.L f'ROM SFR vlq TRENcN BuRin�. No HEMT o� INfULATIOn�, STD STI�K F/�HE W�q}{ 9�/y�IZ <br /> TQUnS GONSTRueTlo�1 RooF. Wa��u -' s��se <br /> PLUMBING MECHA�IICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water hea�er <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clo�hes washer Clolhes dryer <br /> Laundry tray Range hood <br /> Sink(servicelbar/mopletc.) Exhaust fan <br /> BackOow preventer Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> � Other 4�IoSE'g18 (zj52�__ _ _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify lhal I have read and examined lhis application and know the same to be true and correcl. All provisions of laws and <br /> ordinaces governing this�ype of work will be complied with whether specifed herein or not.The granting of a Fermil does not presume <br /> to give aulhority to violale or cancel ihe provision of any olher slale or local law regulaling consiruction or the per(ormance of <br /> construction. Thal.l am authorized by the owner of this property to per(orm the work for which application is made and I comply with the <br /> Stale Contractors Law 18.27 RCW and 296.200 WAC. <br /> � �� �� '�..._ �z/�� /09 <br /> � �naWre of O� r/ onhactor/Aulhorized Agent Date !� <br /> �"> <br />