Laserfiche WebLink
P�RMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 47.5-257-8810 — FAX 425-257-8857—www.everettwa.org <br /> APPLICi,TIONS ARE ACCEPTFD FROM 8 AM TO 4 PM <br /> SITE ADDRESS / PARCEL TAX I.D.p I�E�T# , / <br /> Z(7'q �: � Y"ct,�'l /'2'� � <br /> LEGAL LOTNO. BLOCK TRACT L LJ/��� <br /> DESC. y�c 9 � ��V.C✓tC� �G'� L ✓QJ't �IY+���/ <br /> OWNER -- ADDRESS CITY2IP PHONE <br /> fV,��a Scc�Vo�f `' Je ✓x�n�� �,-��, 9L5-427- 9e 7/ <br /> TEN TNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR ADDRESS C�TY21P PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> QQ S� �`��� �C Eleclric `�Gas_Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel AIC—air handling urils <br /> Balhtub Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler heatar <br /> Kilchen sink 8 disposal ri Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> �Naler healer Range hood <br /> Sinl<(serviceNarhnop/etc.) _ Exhaustfan <br /> Dackflow prevenler _ Hea�pump <br /> Urinal Unil heater <br /> Drinkinc� Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease Irap _ Woodslove <br /> Roof drains Other _ <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAY,CODE IS 3105 <br /> I hereby ceriliiy thal I have read and examined lhis applicalion and know the same to be true and cortecL All provisions of laws and <br /> ordinac^s governin�this lype of work will be complied wilh whether specified herein or nol.The granting of a permit does not presume <br /> to give authority lo violate or cancel lhe provision o(any other state or local law regula�ing construclion or lhe performance of <br /> construction.That i am authorized by the owner of this property t�peAorm lhe work for which application is made and I comply with the <br /> State Contraclors Law 78.27 RCW and 2�J6200 WAC. <br /> - ;`7"�, �<t ��i c d u 5%- 9�/7- rr�o� <br /> SignaWre ot wnedContrector/Authonzed Agenl Date <br />