Laserfiche WebLink
Pt(2MIT APPLICATI(�N <br /> CITY JF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, `dVA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> l,! N 1 f � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> i� i z6 Pk�N � r-�� �u w��r ��53� ODod/� a C o�o�-� �' <br /> LEGA L0T NO. BLOCK TR T OR SUBDIV N#/J / <br /> DESC. j G(i( •LQ `PXdI �� <br /> OWNER ADDRESS CITY2IP PHONE <br /> �g� (<b "�b/•I G' `(3o tc i S�o i � 2�� a�� u� �Y�' ��oa� w� 4��3 7 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> W� �'� E-MAIL <br /> TRA TO A S TY/ZI O <br /> C�bblesron�E co�Gr r,����� l�c ��wr � ks �-Dd�,� 206���4�7�� <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> S�� _Electric _Gas�Other <br /> WORK DESCRIPTION <br /> � �fid�y 1�1� �c �y� <br /> srPA� o�--0�'6 4oxZy- Zo �6 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTl1RE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilel A/C—air handlinc� units <br /> Ba1hWb Forced air syslems <br /> Lavalor�(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kitchen sink&disposal _ Gas(ireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water healer Range hood <br /> Sink(servicelbar/mop/elc.) _ Exhaust fan <br /> Back(low prevenler _ Heat pump <br /> Urinal Unil healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Re(rigeretion <br /> Grease Iran Woodstove <br /> Rool drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TIU(CODE IS 3i05 <br /> I hereby cerili(y thal I have read and examined lhis application and know the same to be true and correcl A�I provisions of laws and <br /> ordinaces goveming lhis type o(work will be complied with�tihether speci(ied herein or not.The granliog of a permit does nol presume <br /> to give aulhority lo violale or cancel Ihe provision of any olher state or local law regulaling construclion or the performance of <br /> constructioa Thal I am aulhorized by lhe owner of this property lo perform lhe work for which application is made and I comply wilh the <br /> Stale CoNrectors Law 1B.°7 RCW and 296.200 WAC. <br /> l�—�� I t-= _ 61�� o� <br /> Signalure o(OwnedCo Ira lorlAulhorized Agent Date �/ <br /> Z <br />