Laserfiche WebLink
PE��iiIIIT APPLICATIO�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> ` <br /> 425-257-8810— FAX 425-7_57-8857—www.everettwa.org /O ` � �_�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE AODRESS ,�?ARCEL TAX I.D.# PERMIT# <br /> 3c�a �1eQ���e.ct �c�c.� �e".� . aca -�l <br /> LEGA LOTNO. BLOCK TRACT <br /> oesc. � l�-1 1 `a�`�•� <br /> OWNER AODRESS CITY2IP PHONE yaS-'�S�C -y� S <br /> F3z�o.��S.�,;��� e�s.�� Ja����e C�.Z,t�a;c�,�-h 3�a Hec���t.z '�2d Eve.zzN q�,ao-3 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE U�op� <br /> ow.�zaS Jacc�:e Cv.2+c�51`��.�,� e•���.\'. ��t�m�y� <br /> CGNTRACTOR �1�Z) ADDRES� CITY/ZIP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��,5�� ���1`�� ��}`��°-�1L� ✓Electric ✓Gas ✓Other����'�1 ��k- TUTc.\ <br /> WORK DESCRIPTION <br /> 'Zl\"�?�U�Z. Cae\'�p/��1udZ\ �..1c_1. W���c1c��3.%S � e\ZctQ�c0.\ v�Ga�' <br /> � =W ����\t�C�' 7\UM��n �� � <br /> ,� —� � l yi �O.l� v\Stcv.\� �15v\0.1�o�1i C\Q�Wc�..L\ � �(20,�1'��(,c� <br /> J <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FIXTURE OR ITEM NO. TYPE OF FIXTVRE OR ITEM <br /> 1 Toilet A/C—airhandlingunits <br /> Balhtub Forced air systems <br /> �_ Lavatory(wash basin) �.; Gas piping <br /> 1_ Shower � Water heater <br /> Kitchen sink&disposal a Gas fireplace <br /> Dishwasher 1_ Gasrange <br /> Clothes washer _� Clothes dryer <br /> Laundry tray � Range hood <br /> � Sink (service/bar/mop/etc.) � Exhaust fan <br /> Backflow prevenler Heat pump <br /> Unnal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Re(rigeration <br /> Grease irap Woodstove <br /> Roof drains Other �2o.c�,c..�+ t�ec�a <br /> Other Q�cx„-i ;� l��n <br /> Rait� <br /> I CITY OF EVERETT LOCAL SALES SAX CODE IS J105 <br /> � <br /> ! I hereby ceritiFy that I have read and examined lhis applicalian and know the same to be tr�e and correct. All provisions of laws and <br /> Iordinaces goveming this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> � '�give authonty to violate or cancel the provision of any other state or local law regulating construction or the performance ot <br /> mstruction.That I am aulhorized by the owner of this property to perform the work for which application is made and I comply with the <br /> �otafe�Contractors Law 18.27�W\ and 296.200 WAC. <br /> /��1� aV \�a,M�e�.yM�c C�a��1h.a��� G\OCTcti.-\ <br /> S, i nature of OwneCContr�Auth�Agent Date �/ <br /> \ i - Y <br /> I \./ <br />