Laserfiche WebLink
1 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 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 -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT k <br /> ^rl �J`i �\-VC�Z <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/LP PHONEy�S'�'�I-/�YS <br /> T�m Gr-ctJc'� lL-- �/ � �cn�l /9��F �dri"�'Tf ulA �/��.2c^/ <br /> TENANT NAME I CONTACT FOR PERMIT —T PHONE <br /> CONTRACTOR n . ADORESS/ . /t CITYZP - PHONE <br /> .ScP,'�zc'�- / lu;r�i ��r2c� /SG�I �1 �1C.5Tt�-;rC�. /�cr• ��nG�7CirtiSl�, U%t'? �/S' Z�%G <br /> CONTR.LICENSEf 5 £�Z �. I� �41(DAG •j�cC- J��-�� 7&� <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> � � Electnc Gas_Other T �� ��n,�2������ <br /> r irl c i �rn� � <br /> WORK�ESCRIPTION [.(P����;�C p/�.rh-t�7i�J �c; �t.3� c�/'�t �•7S �i �7c� C✓��c` r <.C�c-a7�C' <br /> / � (' nl <br /> 1'�1'j�[( �I lil'�/c['1� ic1c�/Gci�C'� /]tic� (��'�Clr ;QS �'Ir-nirtt't YC' t� Q�I" <br /> J <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C-airhandlingunits <br /> �! Bathtub Forced air systems <br /> �_ Lavatory(wash basin) �_ Gas piping <br /> Shower . _ Water heater <br /> f_ Kitchen sink 8 disposal Gas fireplace <br /> _L Dishwasher �_ Gas range <br /> �_ Clothes washer I Clolhes dryer <br /> Laundry tray _ Range hood <br /> � Sink(service/barlmopletc.) _ Exhaust fan <br /> Backflnwpreventer _ Heatpump <br /> Urinal Uoit healer <br /> _ Drinking Fountain _f_ Boiler <br /> Floor drain _ Refrigeration <br /> _ Grease trap Woodstove <br /> Roof drains �_ Other� •r(-,L :�' <br /> _ O�her .��,`�� — <br /> — �(JJ C(' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceritify thal I have read and ezamined this application and know the same to be true and correcL All provisions o(taws and <br /> ordinaces 9oveming this type of wurk will be complied with whether specified herein or�ot.The granting of a pertnil dces not presume <br /> to give authonty to violate or cancel Ihe provision of any other st3te or�owl law regulating consiruction or the perfonnance of <br /> conslruction.Thal 1 am auth i by ihe owner of ihis property to perfortn lhe work for which application is made and I wmply with the <br /> Slate Con�rectors Law]&2 i �d 00 WAC. <br /> , �y, � C -� -7�i�� � . <br /> i <br /> Signature of wnedConirac dAuthonzed Agenl � ' Date <br />