Laserfiche WebLink
PCRMIT APPLICATI�N <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 � lJ���� <br /> SITE ADORESS �3�Yp ��� PARCEL TAX I.D.# ERMIT/! <br /> 03 � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ��r� �„�_` A�I�� • CITY2IP C� F Z�� �� <br /> "-.Y� 1 R�J <br /> 1Y1�'a�t�'..�—_, �.t-►�� ��a.�- L.h �' �� Mclr.� o•• <br /> TENANT NAME CONTACT FOR PER T PHONE <br /> �YI� o.s �`l� <br /> CONTRACTOR ^ �'�"'�DDRESS p�O� � CITY2IP PHONE Cz� <br /> CONTR,LICENSE p ' - '^r "�r..^� Q � ' `D' � �p�` 'w�',`r1'�'� � � <br /> y��....y-�;r-���Y�-� I - �FY�{I'C�S�� - <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �I� ���� _Electric _Gas_Other �' �S��Q <br /> WORK DESCRIPTION ���,' � � � <br /> � F�v,�lafra� • v�e�l�re-� be w,�r�c�l. <br /> q s�1��� �d��i�y ��+� �4 a�-�e. <br /> PLU BING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> Toilel AIC-air handlinc� units <br /> Dalhlub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water healer <br /> Kilchen sink&dispos�l Gas fireplace <br /> Dishwasher Gas renge <br /> _ Clolhes washer j}��i( I( � _ Clolhes dryer <br /> Laundry lray C Range hood <br /> _ Sink(service/badmop/elc.) '� • ,�,i ', ', . � _ Exhaust fan <br /> Backflow prevenler � �% ' _ Heal pump <br /> Urinal ��1 Unil heater <br /> Drinkinc� Fountain Boiler <br /> Floor drain Re(rigeration <br /> Grease lrap Woodslove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify lhal I have read and examined this application and know the same lo be lrue and correct All provisions of laws and <br /> ordinaces governing this lype of work will be complied with whelher specified herein or not.The granting o(a permit does not presume <br /> to give aulhonty to violale or cancel lhe provision of any other stale or local law regulating construclion or the periortnance of <br /> conslruclion.Thal I am aulhorized by lhe owner o(this property to pertorm lhe v�ork tor which applicalion is mada and I wmply wilh the <br /> Stato Contr ctors Law 18.27 RCW and 296.200 WAC. <br /> � <br /> SignaWro ot w Contr clor/Au orize Agent Dale <br />