Laserfiche WebLink
_ . 1 � <br /> PER�VIIT APPLICATION i�'���j� �71 <br /> CITY OF EVERETT PERMIT SERVICES (� �'�5`��� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � � �s <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org ��% <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �— <br /> Sl E ADDRESS PARCEL TAX I.D.# PERMiT# <br /> " > . . v� � � �� 02�D3o0 , �.; ; " - � <br /> AL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 `�" " �1�� ��(!T ���P��'�y PHONE <br /> ��G�'l��l" ��71�1�'G19 � 7���'�!W� G� �%�rG// �Z�� <br /> TENANT NAME � C.�—Gi �f ` �--� O TACT F9,R P IT PHONE <br /> ��7� d��� I���7�/ �'�"c �+=� �rc� �k� C����Z-7�� <br /> ivf'��i !� 1 <br /> CONTRACTOR C�� � A�D ESS CITYIZIP PHONE <br /> CONTR.LICENSE#!�'��W�L�JSB�� �),Cb�uU� l�p�GF �� `/�/,/i�/— �/� <br /> f w ic�•��wa .l'7Y /- <br /> USE OF BUILDING HEAT OURCE CONTRACT PRICE OF WORK <br /> ��n`���G ���f� _Elec! ic �Gas_Other .`��� � <br /> `1 <br /> WORK DESCRIPTION ` <br /> G��:�'1r�i�'/ o�' � Neid������5� �z���v� �ru�G �u��i� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet 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 Gas range <br /> Clothes washer Clothes dryer � <br /> Laundry tray _ Range hood /' /� /I�' '� <br /> _ Sink(service/badmop/etc.) __ Exhaust fan % /\ 1� �.I3 , <br /> _ BackOow preventer Heat pump j� � h , <br /> Urinal Unit heater C� <br /> Dnnking Fountain _ Boiler � jt���U <br /> _ Floordrain _ Refrigeration �{ � <br /> _ Grease trap Woodsrov� �T , <br /> Roof drains Other / <br /> Other � <br /> — — I <br /> _ — ` <br /> \ � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 910D�____�—� <br /> I hereby ceritiy that I have read and ezamined this application and know the same to be true and wrcect. All provisions ot laws and <br /> ordinaces governing this type of work will be complied wiih whether specified herein or not The granting of a permit does not presume <br /> to give author to violate or wncel the provlsion of any other state or local law regulating construction or the performance of <br /> constructio . T l am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Con ctors w 27 � .200 WAC. � <br /> i � <br /> ignat e o wner/Contractor!Authonzed Agent ate <br /> � �(z� <br />