Laserfiche WebLink
PCRMIT APPLICATIG�� <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 /> APPLICA'ilONS ARE ACCEPTED FROM 8 AM TO 4 PM �Z __��j�D <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT p <br /> a�� � .��IL��- r-�-- �o �I39iv76009a� � �z/8�_ <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> �yyNpR E ` l'/�D,_ ADDRESS CITYIZIP PHONE <br /> A�� a <br /> TENANTNA;��� S ��-�,Ly,�p.p�_ CONTACTFORPERIdIT PHONE <br /> .Z� I `7 <br /> Z� n �dlClrlyv� T�� '4-C�cS��".�M� E-MAIL <br /> C NTR CTOR C��� �� ��h' �C•k�� 0 ESS G �),:5�...✓,�,�I- TYI I PHON <br /> C `"�` '��y,7n� �' y�s--��E--�E ,�' <br /> CONTR.LICENSE il � ������ <br /> C���,(r Cr1� U ��O Y <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> S l ll t i L�� f� _Etectric _Gas_Other ��U� <br /> ` " . <br /> �L s <br /> WORK DESCRIPTION Q�n` Cy�I�`�,t� .�Y.r �/� �'j j-(ij��-�• ��� <br /> J� �;�,��-� �� �� � <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTUR[OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tuilet _ A�C-air handling units <br /> 6alhtub Forced air systems <br /> Lavalory(wash basin) �y Gas piping <br /> Sho�ver _ Walerheater <br /> I<itchen sinF�.&disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clolhes washer _ Clothes dryer <br /> Water healer _ RangQ hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Dackllow prevenler _ Heal pump <br /> Urinal _ llnit hea�er <br /> Drinkin� Founlain _ Boiler <br /> Fioor drain _ Refrigeration <br /> Grease lrap _ Woodslove <br /> Roo(drains _ Other <br /> — ein�� _ — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby centify lhat I ha��e read and examined Ihis application and know Ihe same to be true and correcL All provisions of laws and <br /> ordinaces governing this type of work�vill be complied with whether specified herein or nol The granling of a permit does not presume <br /> to give authoriry to violate or cancr.l lhe provision of any other state or local la�v regulating consWction or the pedormance of <br /> conslruclion.Thal�am.aulhorized by lhe owner of this property lo perform lhe work(er�vhich application is made and I comply with lhe <br /> S(ale Cd tractors L� +.16. 7 R �i tl 96.200 WAC. <br /> l� ` .1��.� �/��lrt4C/ �� <br /> 9ignaturo of Owry.dConlraclodAulhonzed A9ent Date <br /> J <br />