Laserfiche WebLink
F �RMIT A�PLICATII.N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-?57-8810- FAX 425-257-8857-www.e�-�ret[wa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� ��6`.�% <br /> SITE ADDRESS PARCEL TAX I.D.'F PERMIT# <br /> `� l�� � r'� ;�t *2 -OI�-I <br /> , � <br /> LEGAL LOT�v0. BLOCK TRACT OR SUBDIVISION# <br /> GESC. �O � <br /> OYiP�Eft ADDRES �q 'r� CITY2IP PHONE „�s <br /> I J r1' �4�7T /' ����� �D �� f11iZ �✓U�7 �✓ 1��� _ � �:i <br /> G V! i � � <br /> TENANT NANE CON f GT FOR ERMIT PHONE���s �6/ ���'� ,t, <br /> /� / �',:,„� <br /> on�� lu�v;9 PA(�il E•MAILT+r '-��A�.I�.�Pl✓�«c,r ;,, � .,.� <br /> GONTRACTOR ADD ESS CITY/ZIP P O E <br /> w2 ;,,� Fo6ox i�z► ,��,-ys�;��,������ <br /> CONTR.LICENSE# A�v 2IrJr � �i�z�q G�y% ��`J 7SS/ <br /> USE OF BUILDING � I HEAT SOURCE CONTRACT PRICE OF WORK <br /> �5�����/�'/ ��� XElectric _Gas_Other ����p�i <br /> WORK DESCRIPTION /' 1 l L ��) L /1 <br /> �t�.STt,�� "�1'�I�W .G.c1�Tt/tGN ��rNu'7S� W���(� �fiO�ww/ 'roOq�i/'oci� <br /> TAS'f��� 1�vL" �O��G/ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> �alhtub Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower . Waler haater <br /> Kitchen sink&disposal _ Gas fireplace <br /> � Dishwasher Gas range <br /> Clolhes washer Cblhes dryer ��i+i <br /> _ Water healer � Range hood _';� <br /> _ Sink(service/badmop/etc.) Exhaust fan <br /> Backflow prevenler _ Heal pump �+ <br /> Urinal Unit healer ���`�' <br /> _ Drinking Fountain Boiler <br /> _ Floordrain Refrigeration <br /> Grease lrap Woodslove <br /> = Roofdrains = Olher � <br /> Other <br /> I 4 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 I �i <br /> fi <br /> I hereby ceritify lhal I have read and�examined lhis applicalion and know the same to bo Irue and correcL All provisions of laws and l��i <br /> ordinaces c�oveming this type of work will Ge complied with whelher specified herein or not.The granling of a permit does not presume ,;:� <br /> lo c�ive aulhority lo violate or cancel lhe provision of any other stale or local law regWating consUuclion or the pedormance of � ..i'�' <br /> conslruction.T a am aulhorized by t �owner of lhis property to peAorm ihe work for which applicalion is made and I comply with lhe i��'� <br /> Slate Contra or aw 1027 RCW an 296.200 WAC. �' <br /> 1 - . , L� �Y �. <br /> Si9naW of wnedContra hor zed Agenl Da e �..�j�r <br /> `— --- ------ ---- -- — �:. � <br /> i''� <br /> n,.—.: ...._. . .. . . . . _ ,.. . . ,- ._.. _ . . _. ,, . - <br /> .. , eYf'a �kzz �i , . <br /> : <br /> � i. .. . :�.GkL �l ' - - � � <br /> � ,r, +,: , . . . ,_ . � � . ..irillli' , . <br /> � <br /> _ _. _. . . . . .�,� ?� <br /> � � _ <br />