Laserfiche WebLink
P��tMIT APPLICATIOh <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C=DAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 42�-257-8857-www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS (� PARCEL TA7(I.D./ P R/ <br /> �z',GL n4 �,T1c .K . �.Kvl �""4 -! <br /> LEG lOTNO. BLOCK '�TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PMONE <br /> SIJV�..� �41���1L �y�V`l�n�j, �>�{�L <br /> TENANTHAME I CONTACTf PERMR PHONE <br /> VC.tkwT �� - �L1 'Z� �' ry/1J <br /> CONTRACTOR ����� ��,.�a [,,,,t}. ADDRESS CIiY21P PNONE <br /> CONTR.LICENSE R <br /> USE OF BUILDING 1 I � HEAT SOURCE I CONTRACT PWCE OF WORK <br /> �. <br /> C`�.,�n..e r �..-. Electric Gas Other V��l J 0 <br /> WORK DESCRIPTION <br /> (�� i.1. <br /> .- �I � �..y I��.r,�.,R � �T'aw. W..�) rR P..�. / '�'^S. <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE Of FOCNRE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> 5hower Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Cbthes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaus[(an <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refriperalion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Olhcr <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS J10S <br /> I hereby cerilify thal i have read and examined this applicalion and krww ihe same to be true and corred. All proviebns of laws and <br /> ordinaces goveming this type of work will be wmpiied with whether specfied herein or not.The granting of a permN does not preaume <br /> to give authority to violate or cancel the provisiun�f any other state or lacal law reguladnp conshuction or the perfortnance of <br /> construction.That I am authorized by the owner of this property to perfortn the work for which applkadon is made and I comply with the <br /> State Contraclors aw 18.27 RCW and 296.200 WAC. <br /> �� /�_ ��/,o/o s� <br /> Signature of Owned ntractor/Aulhorized Agenl Oate <br /> � <br />