Laserfiche WebLink
—� — <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 <br /> SITE ADDRESS PARCEL TAX I.D.f! PERMIT N <br /> is// �;a ,�r�� i�tti� pa� �-; �%, /2v�- `/ov l�� '� �% ' = ? <br /> L[GAL LOTNO. BLOCH TRACT <br /> DESC. <br /> OWNER / ADDRESS CITYIZIP PHONE <br /> /� �i C.�l Gt`( C' c')2�j �=�/� �G��� G�cL �i�<<<�� %��/ y25 �'.�� —�Z�7 <br /> ,�a TENANT NAME , � CONTACT FOR PERMIT PHONE <br /> Ir n <br /> ��.,�',�� n,�)� (�a�_c�� M Cc.:.�!»�,� <br /> �\ CONTRACTOR � /a.-- A�DRESS � ( 1� CITY P PHONE <br /> = � �(JPSNi��/✓A[`��-t�l'LLv;�� j>5�y !y �lc� � 5-�;�n _ <br /> �^ �'��, ONTR.LICENSEA T��'`e(. /rz/L`i n �./�L�:I;{��/LI j� S����'J/�/ <br /> c� ,, l.uRsi�r�x�`%S�i��r `�'S'��3y <br /> 1�i�Y'� ' USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��L� �J �lectric _Gas_Olher ,S (t' y�� <br /> ;�, �� WORK�ESCRIPT�ON � <br /> j� ` • � <br /> �e C� ll'i� •'�C�.� � LG � �� l ,t;ti Cr=�`�'c. GL�i��/' /u���� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Balhtub Forced air systems <br /> Wvalory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/barlmop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Re(rigeration <br /> Grease lrap Woodstove <br /> Roof drains � ,' Other <br /> � Olher iC.-`�=•� �Le c��-[.L _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br /> I hereby ceriti(y that I have read and examined this application and know the same to be We and correcl All provisions o(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 /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the pedormance of <br /> construction. That I am authorized by the owner of this property ro perform the work(or which application is made and I comply H.dth the <br /> Stale Con�ractors Law 18.27 RCW and 296.200 WAC <br /> \\ :A-i,,.ti ..� �,�J.,L4j�-�L- -- 1�.�- - �L�—�. � � <br /> Sgnature of�erlContractorlAulhonzed AgenV Date ,. <br /> � <br />