Laserfiche WebLink
�ERMIT APPLICAT N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM �� �� -�/� <br /> SITE ADDRESS PAR EL TAX I.D.# PE IT N <br /> oia ���--� DO3 ��yoDo����`� C� D -Od <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION 1t <br /> DESC. S Q 3� - ��p <br /> OW R� . ADDRESS CITY2IP �/ � /�PHONE i/ds' <br /> /t �' `f�- ��/aU ���Q�(G�/� � L .t.--v %GS`� % rl7Q U �.$�ol <br /> TENANT NAM CON ACT FOR PERMIT PHONE <br /> ' '�� • � D Gv�''�`-'� ' ' E-MAIL ' ' <br /> � <br /> CONTR.LICENSE# D��� � � �� . ' � �. <br /> �.. <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S�� _Electric ✓Gas_Other �S�°,� <br /> WORK DESCRIPTION <br /> �.�� �� <br /> 3�3�- -s-� �� � � � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilet �� 1 � i AIC-air handling units <br /> � Bathtub � / Forced air systems , <br /> � Lavalory(wash basin) /��)� � Gas piping <br /> Shower Water heater <br /> � Kitchen sink&disposal � Gas fireplace <br /> / Dishwasher Gas range <br /> � Clothes washer� L Clothes dryer � <br /> Water heater Range hood <br /> Sink(service/badmop/etc.) � Exhaustfan'���'� � � � <br /> Backflow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeralion � <br /> Grease trap _ Woodslove <br /> Roof drains Olher <br /> Other — , <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this lype of work wi�l be complied with whetner specified herein or nol.The granting of a permit does nol presume <br /> to give authoriry to violate or cancel the provision of any other state or local law regulating constructlon or the pedortnance of <br /> construction.That I am authorized by the owner o(this propeRy to perform the work for which application is made and 1 comply with the <br /> State Contraclors Law 18.27 RCW and 296.200 WAC. <br /> � `��°-° <br /> Signature of OwnedContracror/Authorized Agent Date I/� <br />