Laserfiche WebLink
PERMIT 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 <br /> SITE ADDRESS -�.�,�� PARCEL TAX I.D.* P M T �„-� <br /> �• �v� � ' � � � � ... �) ' �� � <`, �-�-� <br /> -. , f \ L.4$'LY. �KL.. 1�-Iw ._r� L /C :) t�f� 3 i' I°]C <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYlZIP PHONE <br /> �rl ' •--'�� <br /> ��i Lh n,\i n �� �Ic� cvi C4''�' G'r ✓- �i�4. - `�- Slc: �i 20 4:�.i�k� /�'1a� o-:`�; o „ .'a•. <br /> TENANT NA E I CONTACT FOR ERMIT PHONE y <br /> � ,IiF � Tf[`hr��u1 �F+N�c.2 '� ���:��. �r.��'� �'253��C4—C`/�N <br /> �TRACTOR ADDRESS CITYlLP PHONE <br /> <'_c-r��� G• e�_/r.l,j '����. (�?s3) ��,Y- c�N�` � <br /> CONiR.LICENSE# ( � C.r I I �-1FS� V C,`�E�. �� 1��C-��i C-�Iol�� <br /> � ��n�.�i�. t�l�ti� Y, <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I .,�. — � I �1`I�`� . �� <br /> �,�;�,�«�x.�'f'- Eleclnc Gas_Other <br /> WORK DESCRIPTION �� i,� <br /> ���'�1�.1\ r.n� C.��C.�l��( .��b �(.l'i.yS c;{ �e,`I�,.' � .�+! �, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Todet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> � Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes vrasher � Clothes dryer <br /> Laundrytrey _ Rangehood <br /> " Sink(service/badmopletc.) _ Erhaust fan <br /> Backflow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigera6on <br /> Grease trap _ Woodstove <br /> Roof drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9106 <br /> I hereby ceritify that I have read and examined this application and know the same to be frue and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether specified herein or not The granting ot a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or Ihe performance of <br /> wnstruc6on.That I am authorized by the owner of this property to perform the work for which applicalion is made and I comply H'h the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> , ,'"�? '` �,��I��• <br /> Signature of OwnedContractorlAuthonzed Agent e« �/ <br /> Z <br />