Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G� ...� S�/ v <br />SITE ADDRESS PARCEL TAX I.D. N PE IT N <br />`� ► �1 T a D !I <br />LEGA LOT NO. BLOCK TRACT OR 9UBDIVISION /� <br />OESC. � <br />OWNER A DRESS CITY2IP PNONE �ZS � <br />CNA(Z� <br />TENANT NAME <br />CONTR. LICENSE k ���� <br />USE OF BUILDING <br />VORK _DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilat <br />Bethtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/badmop/etc.) <br />Beckflow preventer <br />Urinal <br />Drinking Fountein <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />ONTA�TFOR <br />�iqm� <br />PHONE <br />HEAT SOURCE cvni Knc i rn�ce ur �vRn <br />_ Electric � Gas _ Other jl Z�' �—J (/ � �� <br />d�- [..� / l., �G+-=.0 ^`J '`� <br />���'°�-- suor <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — eir handling units <br />Forced air systems <br />Gas pfping <br />Water heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Renge hood <br />Exheusl fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Wooderove <br />Other <br />CITY OF EVERETT LOCAL SALES TA7( CODE 19 7106 <br />I hereby certify that I have read end examined this application and know the seme to be true and cortect. All provisbna of laws and <br />ordinances goveming this type of work wil� be complied with whether specified herein or not. The grantlng of a pertnk doea not preeume <br />lo give authority lo vfdete or cancel the provision of any other stete or local law reguletlng conatrucUon or the perfortnance of <br />construction. That I am authorized by the owner of Ihis property to petform the work for which applkatlon ia mede end I comply wNh Mie <br />State Contractors Law 78.27 RCyV and.�96.20y WAC. <br />ia <br />