Laserfiche WebLink
� c 9v�oG,6 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �'� ��S'—O� <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM x �(�� - ;� ! � <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> IIZZ AID6cST ��ST zf�GYu/uo3olz�� �3fJ��—`��� <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CIN21P PHONE <br /> ��L��� �"''�ipJ 1{��a i �-o i U ��G Zv7z��) Yyr�i /k�.��.�1�7�i� �,h�A���n�w'�+ <br /> TENANT NAME CONTACT FOR PERMIT FHONE <br /> ���u�1��--��L �yZ s `C�> 9zZ� <br /> CONTRACTOR ��E�If�- f��LLU�AI(L�FL�IW� ADDRESS 0���� ��!l�����NC�/����'kU7 ��HONE 1j�� 3-(����� <br /> � h r�Os'L <br /> CONTR.LICEN:IE# <br /> 1�1E 2�r�Mi 1C�� Crtij <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> y/ l�I;✓�C=�141"' <br /> _Electric /`_Gas_Other <br /> � <br /> WORKDFSCRIPTION /�KR46L Zl.W,7" I�(-I-$1,$ W/(j✓�UT� Z' �-�����5� <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR ITEM NO. TYP'c OF FIXTURE OR ITEM <br /> Toilet oJC—air handling unils <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Z Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas freplace <br /> Dishwasher Gas range <br /> Clothes washer Cbthes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> _.t_ Backfiow preventer Eleal pump <br /> Uiinal � Unit heater <br /> Dnnking Fountain _ Boiler <br /> / Floor drain Refngeration <br /> Grease trap Woodslove <br /> Roof dn��� Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceriti(y thal I have read and examined this application and know the same to be true and cerrecL All provisions of laws and <br /> ordinaces goveming ihis type of work will be complied with whelher specifed herein or not.The grenting of a permit does not presume <br /> to give auUionty to violate or cancel the provision of any other state or local law reguiating conslruction or lhe performance of <br /> construc;ion.That I am authorized by ihe owner of lhis property to pedorm the work for which application is made and I comply with the <br /> S(ate Conir\rs L�1827�RCW antl,2\200 WAC. �1 \ <br /> \\ . � ��l J� <br /> �,V� � <br /> Signatur OWn dContraclodAu onzed A �nt Date <br />