Laserfiche WebLink
PE�CMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES , s�o <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �z- � 6 <br /> 425-257-8810-FAX 425-257-8857-www.evereriwa.org <br /> � APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS PARCEL TAI(I.D.M PERMIT A <br /> K 3 , B • U(plZ-U3N <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PMONE <br /> ��l�i� ��nv5,� �� f�Ut�w�'� �/o�Gd�.� auc g6v�o/ �1�r 3a3//02/ <br /> TENANT NAME CONTACT FOR PE MIT P�E <br /> S�.►�� c I �tE[�� /:e� � HaS=�/ff-6�17 <br /> ONiRACTOR ADDRESS aCITV2IP PHONE <br /> ,,(/�L�1I�I�ovSrn y /�Yi'Fl�al���{�-� 3�0 7Go��t�- PL'G /g�D� �/��50�-(�5-17 <br /> CONTR.UCENSE M <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> `5 _Electric �Gas_Other � <br /> WORKDESCRIPTION L��j��CsfSp,p�tl -CX/Sy+�1g- �CtS�O�nCG <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIX7URE OR ITEM N0. TYPE OF FIXiURE OR ITEM <br /> Toilel AIC-air handling unils <br /> Bathtub Forced air syslens <br /> _ Lavatory(wash basin) /� Gas piping <br /> Shower ��� Water heater <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer I � Clothes dryer <br /> Waler healer � Range hoad <br /> Sink(service/bar/mop/etc.) Exheust fan <br /> BackFlow preventer _ Heatpump <br /> Urinal Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floor drain Reftigeration <br /> Greaso lrap _ Woodstove <br /> Roof drains Othet <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritity lhat I have read and examined this application and know the same to be We and cortect. All provislons of laws and <br /> ordinaces governinc�lhis lype ot work wili be compiied with whelher specified herein or not.The granling of a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other stale or local law regulatlng construcUon or tha perfortnance of <br /> conslruction.That I am aulhorized by the owner o(this property to pertortn the wark for which application is made and I comply with the <br /> Sta Contractors Law .27 RCW and 296.200 WAC. <br /> a- �� .O� <br /> ignature of Owner o ctor/Authorized Agent Date <br />