Laserfiche WebLink
,_ "�`�v.ro���-( a-�. <br /> Pt62MIT APPLIC�iTI(JN � <br /> CITY OF EVERETT PERMIT EERVECE3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 , <br /> 425-257-8810- FFU: 425-257-8857 -www.everettwe.org ' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � ` aa`�� <br /> SITE ADDRESS PARCEL TAX I.D.# / PERMIT# <br /> � �i-'l L IlV � 0���� �`'� � . � cSIiZ �GC � l � � l, i.��L I� <br /> � LEGAL LOT NO. BLOCK TRACT OR SUBOIVISION k � <br /> DEEC. <br /> OWNER ADDRESS CITY2IP 4fPL�NE <br /> \ 1 �" <br /> �(`'� '�I���,F% �-['� 1�-1'Z f�t�- �e�i ��=:{;�' �S'ZC ) 3c �o7�E� ; <br /> 'fENANT NAtAE CONTAC�FOR PERMIT PHONE L�Z,S-•��(- "71�f� C/ <br /> � ` �N�'�(`���'��_.�1�0�� E!'�M��. i�SI��� �[`��CL � I'iiy� <br /> CONTR��7OR�1(���n ADDRESS CITY/ZIP PHONE C��s' — I <br /> �� '!j C�L�\�Cll't `,U 3'�R-�+b� I <br /> CONTR.LICENSE# � ,i C i <br /> � '� I�.����y_ �Z �' � 3�1 Sv.; CC.n�ah.a ��v. CclMct,�.� �.5 ��2� Z� i <br /> (; <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��T �,�`vr�� I _Eleclric .__Gas_Other _ _ � <br /> ^ � t l'J' <br /> WORK DESCRIP'TlON �- " <br /> ��•v_� e c� � O x ) tS l��', I c� � �b�� 2�t'� ����� C�cy��� ; <br /> l • l f ' I <br /> �=.=-�r��a. �������os � st' ���,,�� Fr' � --- �� <br /> PLUMRING MECHANICAL I <br /> NO. TYPE OF fl%T�1RE OR ITEM NO. I TYPE OF FIXTURE OR ITEhi <br /> i Toilel __ A�'C- air handling unils <br /> ' Bath!ub _ Forcedairsyslems <br /> Lavalory(w:.sh ba•,�n) _ Gas piping <br /> Sho•n�er _ \Naler healer <br /> . Kilchen sink 8 disposal _ Gas firt •lace I <br /> Dishwasher Gas ranye <br /> Clolhes washer Clolhes dryer <br /> I Water healer _ Range hood <br /> , Sink(servicelbaUmop/etc.) _ Exhaust(an � <br /> DackOow prev2rter _ Heal pump � <br /> Urinal Unit healer � <br /> Drinkin9 Fountain _ Boiler I <br /> Floor drain Refrigeration � <br /> Grcase lrap _ NJoodstove '�, <br /> Roof drains _ Other I <br /> I — Olher — -- I <br /> I <br /> � !CITY OF EVERE7T LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceritity that I have read and examined this applicalion and know lhe same to be true and corrcxL All provisions of laws and <br /> orCinaces yoveming lhis lype o(work will b�i�omplied with whether speci(iod herein or nol The granling of a pr,rmit does not presume <br /> lo yive authoriry to violale or cancel lhe pruvision of any olher slale or local law regulating r,onstrudion or Ihe performante o( I <br /> conslruclion.Thal I am aulhorized by ihe owner uf iis property lo perform lhe worl.tor which application is made and I comply with the I <br /> �I $tate-C-oriractors Lav+ 1827 RCW riJ 2P5.200 ' I� <br /> C � � ,� � d� d , <br /> S rt3 ure o( vnerlCon!ractor u iorized Agenl Date �, <br /> �`� <br /> � . . _. _ . ---- - — . . __ _—._ ... .. .--- --- --------- . . .--- __---.__.i <br />