Laserfiche WebLink
�� <br /> _ � ,t >i �l ��/i11G Vi91 I Vt �l� IS 3 <br /> PERNiI�' /�PPLiCAI �06� <br /> CI�1( OF EVERETT PERAAIT SERVI�ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.evereriwa.org <br /> n r ` <br /> APPLICATIONS ARE ACCEPTED FROM B AM TG 4 PM �'(,_) 6 Ci 4'' G'��/ <br /> SITE ADD%ESS /� � PARCEL TAX I.D.x PE�t R�t <br /> 6 3� C ��1� � ' Q�� <br /> LEGAL LO NO. BLOCK TRACTOR3UBDlVISIONi <br /> DESC. �, �� ' O CJ _ - • ' �{,. <br /> OWNER AD RE39 Cf�Y PMONE <br /> �Inv�iv�=^i����m :;��+�,7�1(e �P'v �3c,x ,3��-1 , 19�Ar���,v;��c i,ut� r�a-7n <br /> TENNNT NAME I CONTACT FOR PEHMR PHOkE <br /> ia���ro � ��iVi9 /ZE� raUDE� E�MAILNI�kc./�a��srnl�-�C4;,CE � <br /> G�6� Lc�.cNTrL�� LCNstr�UC71on(, 1n1L• <br /> CONTR.LICENSE f <br /> rt.N�� i�=�� q4��1� P�� r3ox i�o�-l — /?��Q�� �i�/ f �/�i7�> <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> 5 �P�... - _Electric �Gas_Other <br /> WORK DESCRIPTION � <br /> �le(.� Cb�Si-rl..l.G�t�YI - S '—� ��/'-�jIG 5��:� <br /> `4�� " C� v'�' � � „� _C=; c- L: J <br /> PLUMBING MECHANICAL <br /> N0. TYPE OP FlXTURE OR ITEM NO. TYpE OF FlXTURE OR ITEM <br /> .3 Toilet A/C–air handling uni�s <br /> � Balhtub � Forced air systems <br /> � Lavatory (wash basin) Gas piping <br /> � Shower 1 Waterheater <br /> 1 Kitchen sink 8 disposal Gas fireplace <br /> � Dishwasher Gasrange <br /> I Clothes washer � Clothes dryer <br /> � Water heater Range hood <br /> _ Sink(service/bar/mop/etc.) � Exhaust fan <br /> _ Backflow preventer Heat pump <br /> _ Urinal _ Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Retrigeration <br /> _ Greasetrap Woodstove <br /> _ Roof drains Other <br /> O�her — <br /> CITY OF EVEHETT LOCAL SALES TAX CODE IS 310.5 <br /> I hereby ceritify ihat I have read and examined this application and know the same to be true and conect. All provisions ot laws and <br /> ordinaces governing this type ot 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 af any other state or local law repulating construction or ihe pertormance of <br /> construction.That I am authorized by the owner oi this property to peAorm the work+or which application is made and I compty with the <br /> State Coniractors Law 78.27 RCW and 296.200 WAC. <br /> Signature of OwnedContractodAuthorizetl Agent Date <br /> IIZ <br />,�-v' I` <br />