Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER��`ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-6857-www.ev2rettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# /j <br /> � w ? a oZ � n/Sa� � �.,�?�, - i J <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. �� <br /> OWNER A�DRESS CIIYZP PHONE <br /> N'K1�I�— ��E'EIL- (o� ur�IJ��� �]T; �Yl�i1'l�- `2� (d�i-��7?� <br /> ���a�s �.��. s.,� 2a� ��,�� <br /> TENANTNAME CONTACTFORPERMIT y�G, �;��� �, � �-:,j PHGNE ��L�,,,���'� c; �; - <br /> ��s ��� . <br /> ��T� Ptit+�c-T�l�+� �''���-�+-�s�� ���� �zs• zs5'�i <br /> CONTRACTOR ADDRE55 CITYILP PHONE <br /> CONTRLG <br /> ENSE#�A�,�a ISoI ri Zo��, � 5tk�nt� �� 5z-g .zi91 <br /> —�P,c.o�,�4 0 8�41�5 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���G� ��},��� _E�eclric �-6as_Other ��9g Qp� -�.. <br /> , <br /> WORK DESCRIPTION �JG� 5��� �� y`�S �,�P JE-t-- <br /> — � rl T�� <br /> Cl-sLl f1��J . C,�I'�.tZ�i�JS� (-cit. �c."S' �1�a/`t�'� `i- Fy,gT{�-s , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE Of FIXTURE OR ITEM <br /> ,� Toilet _ A�C-airhandlingunits <br /> Bathtub Forced air systems <br /> � Lavatory(wash basin) _ Gas piping <br /> � Shower _ Water heater <br /> Kitchen sink 8 disposal Gas 5replace <br /> Dishwasher Gas range <br /> Clolhes washer Cloihes dryer <br /> Laundry tray _ Range hood <br /> � Sink(service/badmop/etc.) F�chaust fan <br /> Backflow preventer � Heal pump <br /> 2� Unnal Unit heater <br /> � Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> � Other Eyr c.MS+/ _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby ceritify that I have read and examined this application and know lhe same to be true and corcect. All provisions of laws and <br /> ordinaces governing this type of work witl be complled wiih whether specified herein or not.The granting of a permit does not presume <br /> lo give authority to violate or cancel the provision of any olher stale or local law regulating construction or Ihe per(ormance of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State /j�hadors Law 1/S.�2i RC nd 296.200 WAC. <br /> ! � T 'f-4L`'�� (�I'(o/VS-� <br /> �gnature o wnedContractor/Authonzed Agent ��D �— �/ <br /> � L <br />