Laserfiche WebLink
NERMIT �PPLICATIVN <br /> CITY OF EVERETT PERMIT SERVICES i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 II <br /> 425-257-8810- FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> SITE ADDRESS �',-r'R�Y � PARCEL TAX I.D.# I PERMIT# I. <br /> , � ^ ; , -��� ; i.'�' �I � `'"� / � �'�U�51 � - oo} <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION fi � <br /> DESC. <br /> OWNER ADDRESS CITY�27IP PHONE <br /> � ! �� n <br /> / � � � , - ; , �rl j� ��� 9,i�ru�,-� <br /> '�� n. • ( � � -� � u dc' �, <br /> / r_ �, rr �rYL /�iI" J n �,�f <br /> TENANT NAME r ) CONTACT FOR PERMIT P �ti� {��J-'.`��' j!� I <br /> " I�� � � /��,��;�,�� r�J�' � �-:- � � � <br /> E-MAIL <br /> CONTRACTOR . ' <br /> ADDRESS CI /ZIP PHONE I <br /> .. � @ /.v , " , . N' /� � �,,��. , <br /> �;��r(,., l � � j{,i%fJ /:a >�rR.- i f, • ��� ,_, / <br /> CONTR.LICENSE i! „ �/1 � / 1/^i/f,�/���'�� I/ � ��V, / '� <br /> ���t��1Fn� WW�O' rJ{�l) ' I <br /> USE OF BUILDING � HEAT SOURCE QNTRACT PRICE OF WOP.K � <br /> , ����') (� �/ � x Electric _Gas_Olher ��� � � ✓ v� � <br /> �Ji r,�' , � �� <br /> WORK bESCRiPTION . <br /> �; �(',i> /',;�i' �✓' Y .C' �L �lJ���'{ '' ' ' /�'� �^r'�j� �' <br /> % , , �- ;; <br /> PLUMBING MECHANICAL I <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ AIC-air handling units I' <br /> BathWb _ F�rced air syslems . <br /> Lavatory(wash basin) _ Gas piping i <br /> Shower _ Walerhealer <br /> Kitchen sink 8 disposal _ Gas(ireplace I <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clolhes dryer <br /> Waterhealer __ Range hood <br /> Sink(servicelbar/mop/etc.) _ Ezhaust fan <br /> 6ackflow preventer _ Heal pump <br /> Urinal __ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floordrain __ Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains _ Olher <br /> Olher — . <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritity Ihat I have read and examined this applic2lion and know lhe same lo be irue and corred. All provisions o(laws and <br /> ordinar.es yoveming lhis lype of work will bc compiied wilh whelher speci�ied herein ur noL The granting of a permit does not presume <br /> to give aufhorily lo violate or cancel Ihe pryvisiofi�(any olher s�ato or loca!law regulating construciion or the periormance of <br /> construclion,That I am aulhorized by lhe pwn�r df lhis proper7y to peAorm the work for v;hich application is made and I comply wilh lhe <br /> State-Con�re tors Law 1827-ft4�N(2nd 29G2 WAC. / <br /> / <br /> ' , „ /J_ � <br /> � / � <br /> �.� � .- r � i. <br /> Sign rel � �edContra or/ ut tl ' edAg �t �Dale / � <br /> � � — --- — � , <br /> I ; ` I <br /> �----�--- --- ..----- � - . . . -------- ---- <br />