Laserfiche WebLink
,� <br /> , ,�' � <br /> PERMIT APPLICATIOW <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT, WA 98201 �/- �d -O -7 <br /> 425-257-8810-FAX 425-257-8857-www.evereriwa.org <br /> Ae'PLICATIONS ARE ACCFPTED FROM 8 AM TO 4 PM �� / �� �� <br /> SITE AD�e2ESS PARCEL TAX I.D.� PERM�T N - <br /> 3,�'f D� �n�`�� �� e�� Jr . �U�5 GCcxG�c3o1 � ?0�- 0 D� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESG. � S�.; `Iy �{ +I,e NE '/ �.� j,,�i . 7 T.�;�v �_�r:,v, ti�c SC <br /> OWNER ADDRESS CITY2IP PMONE <br /> � .�.,W«e �11r-4�s-i��� .L <br /> (�r� �� i'-- ���C�tic��. I ?,C' i5 �'��„r-�IfeS .�(�J,��.� OS-LI3 �`/ c����,7 <br /> � <br /> TENANT NAME I CON�ACT FOR PERMIT PHONE <br /> � <br /> �7C:i.,-7E�1- __G,7 7.S <br /> �' h ,'', �� �'.u.�k_iv� <br /> CONTRACTOR `�,,Mz r.�, L..:�nt_( ADDRESS CITYIZIP PHONE <br /> CON7R.UCENSEX /-�r��i�ly 1-'L`ii;,�j V' <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �� C� _Electric / Gas_Other T�' 1`-�(-� , C�G�'' <br /> WORK DESCRIPTION � �_� <br /> %3�+ c. a � j .a��o%� ��.� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet FVC-air handling units <br /> I Bathtub Forced air systems <br /> � Lavatory(wash basin) �� Gas piping <br /> � Shower � Water heater <br /> I KitGien slnk 8 disposal � Gas fireplace <br /> � Dishwasher Gasrange <br /> � �r Clothes washer Clothes dryer <br /> � Laundry tray � Range hood <br /> Sink(service/badmop/etc.) � Exhaust fan <br /> � BackFlow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Dnnking Fountain _ Boiler <br /> Floor drain Refrigerztion <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby centi(y that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work Hill be complied vnih whether specified herrin or not. The granting oi a pertnit does not presume <br /> to give authority to vio�ate or cancel the provision of any other state or local law regulating construction or the performance ot <br /> construction.That I am authorized by the owner of this property to periorm the vrorA for which application is made and I comply with the <br /> State Contractorslaw 1827 RCW and 29G200 WAC. <br /> :� � � ��, 1,,�,�� �� :��� <br /> / `� C <br /> Si'gnature of OwnedContlador/Authonzed Agent Date _� <br /> � <br />