Laserfiche WebLink
rERMIT 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 <br />CEL RCEL TAX I.D. # PERMIT # <br />SITE PAR <br />-7-72o �01; � 7 ►z3�000Zoo - —1 B, ob, - C)lg <br />LEGAL LOT N0. BLOCK TRACTOR SUBDIVISION # <br />Desc. 2, 3 .+ R 4 N W V+ 121-2S 1ZD l�1yLI� tA1.� w <br />OWNER ADDRESS CITYIZIP PHONE <br />na�y�oN Pas�K � G./�I LI.`� iz `h�} oU�6 w�'I', Sr6 Zri1 n 1�$l0l L?DIP <br />TENANT NAME <br />CONTACT FOR PERMIT PI10NE L�4Z5� 02 7 - ZYt OCC)CO <br />1 <br />y) ,I W%(X G^�Mv <br />& T tEMAIL <br />T CTO \ LU�rlolJ ADDRESS CITYIZIP PHONE <br />J 0575 W)��.vw�'�. y"cJPnlwA- <br />CONTR. LICENSE # 7�•,I I Q$�z <br />1 t <br />USE OF BUILDING <br />HEAT/SOURCE <br />CONTRACT PRICE OF WORK <br />G1'1 Z-61 00/GjR E(�j `19—> <br />_ Electric N/ Gas _Other <br />WORK DESCRIPTION l <br />6oN5rTZ41LTicAJ of ISEV4 L- i-i'j�,t& H-17,AN1-> :FULL, trEII-'tm 1z-ii-LLAi• IpflI.L <br />f,/,v -rwt, IKT--vTZf/7R- OPEIJwt-,ems AAjt7 V%VVIP(7 h)1'W 1),joK-- <br />17EWto1w1`rlaN of INi�fZtatz-V1�kll�. tJo �iIT Wv►a� <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. I TYPE OF cIXTURE OR ITEM <br />Toilet <br />A/C - air handlino units <br />_ <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />_ <br />Clothes w sher <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mopletc.) <br />_ <br />Exhaust fan <br />_ <br />Backpow prevenler <br />_ <br />Heal pump <br />_ <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />_ <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application Is made and I comply with the <br />State Conti. tors Law 18.27 RCW and 296,200 WAC <br />�A A U <br />Signature of Owner/Contractor/Authorized Agent Date <br />