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 B AM TO 4 PM <br />SITE ADDRESS <br />C G oll <br />I PARCEL TAX I.D. i <br />C'0 <br />PERMIT If <br />LEGA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION If <br />DESC. <br />O HER ADDRESS CTTYIZIP PHONE <br />21 9220 WIN , 6vcve tfi0 A <br />TENANT NAME <br />I CONTACT FOR PERMIT A40HE <br />E-MAIL <br />CONTRACTORCIT"LIP PHONE it ZS <br />�ve�r' Apt <br />a�eK Ttll►x Z5 % '/totr <br />cu ONTR.axSEr f Osccl I�YrL r futderf;Wr4 RB I <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />}e. 1Ot'ItQ. Electric —Gas _Othe r S <br />-/D `I-I — I <br />(WORK <br />DESCRIPTION <br />0e tjo 1,4 jocA ©� <br />3 G C-b ;!52 <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR REM NO. TYPE OF FIXTURE OR ITEM <br />T ilel <br />AIC ha ling units <br />athtub <br />Forced airs tams <br />vatory (wash basin) <br />Gas piping <br />Shower <br />Water he er <br />Kitchen sink & disposal <br />— <br />Gas If ace <br />Dishwasher <br />— <br />as r <br />I dryer <br />Clothes washer <br />ater heater <br />— <br />R a hood <br />k (servtoe/bar/mop/ete.) <br />he t fan <br />— <br />Ba low preventer <br />Urin <br />— <br />eat <br />Unit heate <br />_ <br />_ <br />Drinki Fountain <br />Floor d n <br />Boiler <br />Refrigeration <br />_ <br />Grease t <br />Woodstove <br />Roof drain <br />Other <br />Other <br />— <br />CRY OF EVERETT LOCAL SALES TAX CODE IS 310S <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 state or local law regulating construction or the performance of <br />constru ' . That 1 am t rized by the owner of this property to perform the work for which application is made and I comply with the <br />on dons RCW and 296.2U0 WAC. <br />7 0 <br />X <br />of OwnerlContractorlAuthonzed Agent Date <br />