Laserfiche WebLink
P�r�MIT APPLICATi�inl <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRES� PARCEL TAX I.D.t� PERMIT/ <br /> Z 3 z p:, e S � Moso�I-o2s <br /> LEGA LOT NO. BLOCK TRi',CT <br /> DESC. <br /> OWNER ADORESS CITY2IP PH NE <br /> ,T�n le�v/fe 1-3Z3 /�%�a ST �drr.�`y/r9 �20/ 5`ZS- z sz-8z8o <br /> 7ENANTNAME I CONTACTFORPERMR PHONE <br /> CONTRACTOR�t-r�Qnr f��. S•r/tS�,sc✓'d�S�t�DRESS CITY2IP PHONE <br /> ,3E'O/�vl.�Xf`/9iK �-rjl,,.af- !�2 S% ZS-`J-Z/�'� <br /> CONTR.UCENSE N �y�� A��5,5 O y 2 I�{2 9�j�� <br /> Cf <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �) I�S �c%'izC.(„ ,�Eleclric Gas Other l/S3o� <br /> WORK DESCRIPTION / / <br /> /7P�t � �n��J S� f�/� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUCTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> _ Toilet A/C—afr handling units <br /> Bathtub � Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 dfsposal Gas ftreplace <br /> Dfshwasher Gas range <br /> Clothes washer Clathes dryer <br /> Laundry tray Range hood <br /> _ Slnk(service/bar/mop/etc.) Exhaust fan <br /> _ Backflow preventer � Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Bailer <br /> Floor drain Rehigeration <br /> Grease trap Woodslove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this applicalion and knaw the same to be true and cortect. All provisions of laws and <br /> ordinaces goveming this type o(work will be complied with whether spec�ed herein or not.The grantlng of a pertnit does not presume <br /> to give aulhority to violate or cancel the provision of any other statc or local law regulating construction ar the perfortnance oi <br /> construction.That I am authorized by the owner of this property to perform the work for which applicadon is made and I compty with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> �-��`�l'G�� �i-.za o,�-- <br /> Signature o OwnerTContractodAuthorized Agent ate <br />