Laserfiche WebLink
P�RMIT 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 g � �—� / <br /> SITE ADDRESS PARCEL l"AX I.D.# PERMIT � <br /> G <br /> .�'_�:,� � C7rn�l r"�Yc � <br /> LEGAI. LOT N0. BLOCK TRACT OR SUBDIVISION K <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> �-+�12„1 �LLC' --t�Z � nl-�C\�3� C.�����."r Z.;c:�� c�..�� ra.ti � L-rucn'T1 �.�,n 9L1.:� <br /> TENANT NAME CONTACT FOR PERMIT PHONE 4ay •7Sv •3 S'v�a <br /> �-A'=� ��l-YbL� E•MAIL fl�nc.:\ . Ihr�je,;�,.+.���, <br /> CONTRACTOR ADDRESS CITY�ur rnvn� <br /> CONTR.LICENSE# C/��`���GS��� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��+����4 I _Eleclric C Gas_Other <br /> WORK DESCRIPTION <br /> (y�ti t-�^.e i.viMN�sn - b�i Qfw �7U �� �=�n-aiPi.f�c-c M�.1 u�s .�nrL4. nrn� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC-air handling units <br /> Balhtub Forced air syslems <br /> Lavatory (wash basin) 1� Gas pipinc� <br /> Shower Waler heater <br /> Kitchen sink &disposal 1 Gas lireplace <br /> Dishwasher � Gasrange <br /> Clolhes washer _ Clothes dryer <br /> Waler heater Range hood <br /> Sink(serviceNadmop/elc.) _ Exhaust fan <br /> Backfiow preventer _ Heal pump <br /> Urinal _ Unil heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roo(drains � Olher �-F'� •`�"� htr,��� <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify lhat I have read and examined lhis application and know th�e same to be true and correcl All provisions o(laws and <br /> ordinaces goveming this lype of work will be complied with�vhether specilied herein or noL The granting o(a permit does not presume <br /> to give aulhorily to violate or cancel the provision of any other state or local la��regulaling construction or the performance of <br /> conslruclion.Thal I am aulhorized by Ihe owner of this property to pe�form lhe work for which applicalion is made and I comply wilh lhe <br /> I Slate Contraclors Law 18.27 RCW and 296.200 WAC. I <br /> , I <br /> �.��--�—I C:,�o71c:�1 <br /> /��— <br /> Signalu�i Owner/Contractor/A thor¢ed Agent Date <br /> / <br />