Laserfiche WebLink
( 1 <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 FROM 8 AM TO 4 PM 3 -3 +- �� <br /> SITE AUDRESS PARCEL TAX I.D./ PERMIT N <br /> (�l� ��� J� �2 OS o00 oS S�o ,� l0 3 -oo� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDINSION�I <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> ���� Zo��l�, a��� ��,�e 5'f- �✓o►-e7�', ,�),� q8�)� l <br /> TENANT NAME CONTACT FOR PERMIT PHONE[faS '3 7 7'��YI�/ <br /> U �l%'(.l �'� e�a��h L(x -e�4 �C�1'1 <br /> (,���� �� ��' ��� G-�w� s ra�-- <br /> CONTR.LIC E I <br /> <<� ���t-iiN�N3i �7 a(�r� Ce�. �n��� �2�[ �- � �1�,�e� �D`/ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Eleciric �Gas_Other I a� <br /> �/, 1��. <br /> WORK DESCRIPTION <br /> —}��.� ��� ���Sh��_ Jc�� {��.��- �t� s� v- � �� S-h� i�u� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub � Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler heator <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> VJaterheater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> BackOow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boilcr <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3705 <br /> I hereby certify that I have read and examined this application and know the same to be true and correcL All provisions of laws and <br /> ordinances governing Ihis type of work will be complied with whether specified herein or not.The granting of a pertnil does not presume <br /> to give authonty to vio�ate or cancel the provision o(any other slale or local law regulating construction or the pertormance of <br /> construction.That I am authorized by the owner of Ihis property to peAorm the vrork for which application is made and I cemply wilh the <br /> Sta e Contractors Law 78.27 RCW and 296.200 WAC. <br /> �� ,�i,l � L(.C.�L'k-1 ����/� <br /> Signature of OwneqConhacror/Authonzed Agent ' Date <br />