Laserfiche WebLink
J <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.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT N <br /> �,�, �a„� � ;--�z�� � «�, s r'Glr-� <br /> LEGAL LOTNO. BLOCK TRACT I <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> CO/i!>jL C'.5��'�f- <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ADDRESS CITYIZIP PHONE <br /> ��,t�/j�nlSJ•� /'L�7�li� ��-� ,� `� 33U �j. yi:� .11vc" i�,L�yC� S J�/L Z <br /> CONTR.LICENSE7l n1C �.C't�.. 4•;jJti. <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> 5 T-i� Electric Gas_Other ��� ��v <br /> WORK DESCRIPTION <br /> in�siAc� F�Ri- SJ'•���--'l� r_L-�� s _�S�Z� ia�/ n/ C��, sf� <br /> PLUMBING MECHANICAL <br /> N(1. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling uNts <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> �aundry tray _ Range hood <br /> Sink(service/bar/mop/etc.) [xhaust fan <br /> BackOow preventer Heaf pump <br /> Urinal Unit heater <br /> Drinking Fountain 8oiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> � _ Roof drains Olher <br /> _ Olher � Si��in�rtL�'�' /�L=`4�t��' <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> I hereby cerl6y that I have read and examined this appllcation and know the same to be true and correcl All provisions of laws and <br /> nrdinaces goverNng this type of:•rork will be complied with whether specifed herem or noL The granting of a permit does not presume <br /> to give authonty to violale or carn;el the provision of any other state or local law regulaling construciion or the performance o( <br /> wnslruction. That I am authorized the owner of this property to pertorm the work for which application is made and I comply with the <br /> State Contractors L w 1827 RC d 296 200 WAC. <br /> �? / 7 �L%�� <br /> l ' <br /> Signature bf Owner/Contracto/Authorized Agent Date <br /> I/,z <br />