Laserfiche WebLink
P�r2MIT APPLICATIO��I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-tz810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FRCM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCFL TAX I'.q.N PE MIT/ i <br /> i�i� i��,���-�- F����, w,� ��us Lro 3 �/ (���Dd5 �x� Sb 3 - s <br /> IEGA LOTNO. BLOCK TRACT <br /> (:�SSC. <br /> ' �)k;'NER n ADDRESS CITY2�P PXONE <br /> �G-7r' S�l��v 1'ap,�S Zc�zz�-3o�i <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � [xSN c(L <br /> n t'i�,f/�'�!f � SG�k�`"� T2 �'zSY`Z3C 5��''I <br /> CONTRACTOR ADDRESS CIIYRIP PHONE <br /> CONTR.LICENSE N / <br /> �/�lL'.'� � <br /> USE OF BUILDING FiEAT SOURCE CONTRACT PRICE OF WORK <br /> '� Electric �Gas Other ��-U (� <br /> , � .___v — — — <br /> WORK ESCRIPTION IJC.�����,G �,/( U�.,��r g,{rl}Caa^, P2N' SfN.r� 2 1�/M�0 w'liJHS� S!Nl1� <br /> /' <br /> �7 rfr2 �:v/C, �[cclL D��a11N'i G�fr 7��. ��O/p�v oF p.vE Lv�-cc.. WUPlit2 �-2 <br /> dD0/11�'w'�'L t�P7M�a�,, wazc �,�. !Gr tz�f�'� �FFICC . /YZiP SINK <br /> PLUMBIhG MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> L� Toilet A/C-aIr handling un(ts <br /> Bathtub � F��- <br /> �"Lavatory(washbasin) '►� ' <br /> Shower 1 _ Walerheater � <br /> Kitchen sink&disposal�' _ Gas fireplace � <br /> Dishwasher — � <br /> _ Ctothes washer Clothes dryer l� � � �t7 ' <br /> _ Laundrytray ��7 y <br /> _ ink(service/badmop/etc.)�� _ au � � nQ// <br /> _ Backflow preventer _ � <br /> _ Urinal _ Unit heater C f�� ( <br /> Drinking Fountain Boiler � � <br /> � Fioor drain _ ' <br /> � ✓ Grease trap _ Woodsro p/z� o u�w <br /> Roof drains v Other <br /> Other <br /> � — • <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 7705 <br /> I hereby ceritify that I have read and examined this applicatlon and know the same to be true and correct. AII provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The grenting of a pertnit does not presume <br /> � to give �uthonty to violate or cancel the provision of any other state or local law regulatlng consWction or the perfortnance of <br /> � construction.That I am uthorized by the owner of this property to perform the work for which applicatian is made and I comply with the <br /> � Sta� t L 18.27 RCW and 296.200 WAC. <br /> i �.��il� � 3 c� v� <br /> Signature of GwnedContractodAuthonzed Agent Dat I IeZ„ <br /> I <br />