Laserfiche WebLink
I�RMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES � <br /> �200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 8..3..,�y� <br /> SITE ADDRESS PARCEL TAX I.D.N PERMR/ <br /> Z z t.� aoeoz o2 0o C 7010-¢ <br /> LEGA LOTNO. BLOCK 7RACT <br /> DESC. ' <br /> OWNER ADDRESS CITY2IP PHONE It.�•9�� <br /> }�EAitb l�htiL-�i I nl c. 'I�l(o I��STS� �Nel+owtrSH g$�'i l. , <br /> TENANTNAME CONTACTFORPERMR PHONE <br /> I KE►-� l�ca--�t 4 -330�9,1 t�t <br /> CONTRACTOR �� �b�� ��L, �DRESS CITY2IP PHONE <br /> "j�it6 �� STS�. St�lotik.�2`t� �l�330�t1tg <br /> CONTR.LICENSE X�Ea.��=65 2�F / Z�7 "9/ <br /> USE OF BUILDING N�'� HEAT SOURCE CONTRACT PRICE OF WORK <br /> s�'R _Electric �Gas_Olher �� <br /> WORK DESCRIPTION <br /> �f.G(� /��LSP � �S(C1 2'�' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FO(TURE OR ITEM <br /> � Toilet A/C—afr handling units <br /> Bathtub � Forced air systems <br /> � Lavatory(wash basin) t(� Gas pipfng <br /> � Shower Y Water heater i <br /> � Kitchen sink&dlsposal � Gas fireplace <br /> � Dishwasher � Gasrange <br /> Clothes washer � Clothas dryer <br /> � Water heater � Range hood <br /> i Sink(^,ervice/bar/mopletc.) 5� Exhausl fan <br /> Backflow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountafn Boller <br /> Floordrain I Refrigeration <br /> Grease trap _ Woodstove <br /> Roo(drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify that I have read and examined this application and know the same to be hue and correct. All piovlsbns of laws end <br /> ordinaces governing Ihis rype of work will be complied with whether specfied herein or not.The grantl�g of a permit does not presume <br /> to give authoriry to vfolate or cancel the pro:ision of any other state or lacal law regulating constructlon or the perfortnance of <br /> construction.That I�� uthorized by the owner of this property to peAortn the work for which applicatlon is made and I comply with tlie <br /> St�e Co actors�w�27 RCW and 296.200 WAC. <br /> � � C.-5' C1Z <br /> Signature ot Owne ContractorlAuthorized Agent Date L'.i <br />