Laserfiche WebLink
PERMIT APPL�GA,`�ION <br />CITY OF EVERETT !'ERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA �8201 <br />425-257-8810 -- FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTEC FROM 8 AM TO 4 PM - DEBIT & CREDI7 CAR�S ARE NOT AG�EPTED <br />SITE ADDRESS PARCEL '�AX I.D. # PERMIT # <br />� qo(, a — _ �n�� e��,�+.t#� <br />LeGFL LOTNO. BLOCK TRACT <br />J'=�'r 5 � S d <br />� <br />TENANTNAMG t�ti�y; �f CJ�+n.� <br />u, , ,�� <br />CONTRACT'�R <br />CONTR. LICENSE # <br />�n���ovi. <br />.v/` ..--- '"^T-�.�,—�� <br />r <br />CONTACTFOR PERMIT <br />L� <br />�,�/ �SAfl�.,� <br />„/� -�/ (__ � AOURESS <br />/) I u'�1 —r� / <br />�.il_,'f a,C L)ti� �l 61-u l� � <br />�r�; � iJ!l�r.,/.e �—v <br />USE OF BUILDING <br />in�%\v �-c�_ 5 � / <br />NlORK DESCRIPTIOI� <br />HEATSOURCE <br />_ Electric �Gas _ Gther <br />CIN/ZIP, PHONE /,�C�J <br />�� .� c <br />t�/������ ,y Z�lj,_`���Gj <br />nr�Ync�n Ci.A <br />P ONE <br />�zsJ 7,; 4�`/L, <br />CITY2IP PHONE <br />i �UNTRACT PRICE OF WORK <br />� ���-, �,� � ( ° �vi �� �� ��-e � � <br />PLUMBING MECHANlCAL <br />N0. I TYPE OF FIXTU �' I ^•^^ ^• �••,T� ��•� ^�• ,Tc.. <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountzin <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />` ,,'� �P �,� .S � , U 'TJ � U 7 /�--�� ` 7? c� <br />1 <br />��)Gn-C � /`�G� SS !<�C<-� . C,�� �'�-�� <br />� V <br />� <br />��� �/G�c�l � '�zi <br />��� �:<,..,� / <br />(1hR <br />,� cr C,K� <br />�a�,� ����/��u C�� {Z, <br />S l- �/'! > S �/�-�LT C � � <br />�� I <br />�.i i � vr cvcnc � i w...�.....�� .. ..... ......"" "' <br />I herehy ceritify that I have read and examined lhis application and know the same to be true and correct. P.II provisions of laws and <br />ordinaces goverrin� this rype of work will be complied with whether specified nerein or not. The grertirg of a permit does not presume <br />to give authonty to viola;e or cancel the provision of any oiner state or local law regulating construction or the peAorman�e of <br />cunstruction. Th�t I am authonzed by the owner of this pmperty to periorm the werk for which application is m�de and I compiy wilh the <br />State Contractors La�.v 1827 RCW and 296.200 WAC. <br />Signature of OwnenContractonAut� d Agent � D2te �L <br />