Laserfiche WebLink
-{ i - <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 FROIYIB AM TO 4 PM )�— aD—O <br /> SITE ADDRESS PARCEL TAX I.D.x PERMlTCiif <br /> Z`T3+1 �P.4u,avie�.a �LvD. �Vltt"T � D '!>GY>� 3 �d� ` � �7 U� � - Q <br /> LEGA LOT NO. BLOCK TAACT OR SUBDIVISION R <br /> oesc. g3 oeo y-ol � E �Ew V. Z "� Y. <br /> OWNER 4 GkRl3T/AIA ADDRESS CITY21Pe��� PMONE <br /> `r'�,..�eTK� P,�.-rrezs�,� z��+ �N��k� �..u� tvE�-rr y25-si9-4zz�F <br /> TENANT NAME CONTACT FOR PEHMIT PHONE c�2S•H�y=�j2.Z s� <br /> Y��,),pTNu $ GNR-��TWA y.6 14}Snn�.B <br /> PaT'rt25o I CH�/�'r�,yA �,a7TE25o%/ E�MINL � �1.eo.�vN1 <br /> CONTRACTOR ADDRESS CITYlL�P PM NE <br /> CONTR.LICENSE M <br /> USE OF BUILDING HEAT SOURCE_,���O ' I CONTRACT PRICE OF WORK <br /> � �f� <br /> 1ZrS/DENT1l�L _E�ectric ✓Gas_Other N�a <br /> WORK DESCRIPTION <br /> �Ay�jy&C j Gr74S LI �.tE S�19TALLAT/D� �21tJ� TD �IETE,� <br /> GDNNE GTI o,v. <br /> PLUIIABING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> _ Toilet A/C—air handling units <br /> BathWb � Forced air systems <br /> Lavalory(wash basin) � Gas piping <br /> Shower Water healer <br /> Kitchen sink&disposal Gas fireplace <br /> _ Dishwasher � Gasrange <br /> Clothes washer C�othes dryer <br /> Water heater Range hood <br /> Sink(servicelbar/mop/etc.) Exhaust fan <br /> Backllow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Retrigera�ion <br /> Grease Irap Woodstove <br /> Rool drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> I hereby cerili(y ihal I have read and examined this applicalion and know the same to be true and correcl. All pro��isions of laws and <br /> ordinaces governing ihis type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> lo give authority to violate or cancel ihe provision ol any other slale or local law regulating construction or ihe performance ot <br /> construction. Thal I am authorized by the owner o(this property lo perlorm the work lor which appiicalion is made and I comply wilh the <br /> State Conlraclor Law 18.27 RCW and 296.200 W�C. <br /> �l�wf� �t/• �ft%c.I�n� <br /> Signature ot ner/Coniractor/Authorized Agent Date <br />