Laserfiche WebLink
s <br />PI-RMIT 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 />PARCEL TAXI.D.0 P RMIT # <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ( ADDRESS CITY/ZIP PHONE <br />c 4wlllll? <br />r h ;t �Ve n �t <br />TE A T NAME CONT CT FOR PERMIT PHONE <br />tfZS:)—)2__ � <br />---- <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />� P I <br />/� J S <br />_Electric _Gas _ Olhern(Jq,c. <br />v <br />WORK DESCRIPTION <br />F 41 __ <br />C coo <br />PBING - MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR!. =M <br />Toilet <br />— <br />A/C — airhandlingunits <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />_ <br />Water heater <br />_ <br />Kitchen sink 8. disposal <br />__ <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />__ <br />Heal pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />__ <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />Roof drains <br />Olher_ __ <br />_ <br />Other <br />- ---- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify 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 slate or local law regulating construction or the performance of <br />construction. That I amr�uutl rized �1y the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors L'aW 18.- 7 RR and 296.26D WAC. <br />Signatuye of Owner/Contra or/Authorized Agent Date <br />