Laserfiche WebLink
. 2 � IO�� z��� 3�0 <br /> � ' t t <br /> 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.# PERMIT N <br /> Z iil Mo� K�,� ��, � 5�i oo z6� � � '= oa <br /> LEGAL LOT NO. BLO�7CK TRACT OR SUBDIV�IS/ION N <br /> DESC. •�����C G� � /�nC //v/'Sr <br /> OWNER ADDRESS CITYIZIP PHONE <br /> �v :IliH+r� ���s zi// /•�kn�e �ti f��...�y G/,yr„3 �Zti-3�3 -� � <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> E�uIAIL <br /> CONT ACT R �v�,1� Si'.I. CIS.���'� At6Io3 !V4� �0+ ` hYL//1.0`� c/�CS_� !/Z� p�!-7`JZ� <br /> J <br /> CONTR.LICENSE# A`�\CJf�'ti1 C 1 ��G� <br /> 1� <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �Electric _Gas_Olher (p A�d <br /> WORK DESCRIPTION p <br /> �`�. Nen-� PJr� 1 � Efi�� 1,J 9 a S �(.. <br /> V <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilel _ A/C—airhandlinc�units <br /> Balhlub Forced air syslems <br /> Lavatory(wash ba. n) Gas piping <br /> Shower Waler heater <br /> Kdchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes wasner Clothes dryer <br /> Water heater Range hood <br /> Sink(service/barhnop/etc.) Exhaust fan <br /> Back(low preventer _�_ Heal pump <br /> Urinal Unit healer <br /> Drinking Founlain _ Boiler <br /> Floor drain Re(rigeration <br /> Grease trap _ Woodslove <br /> Roof drains Other <br /> Olher — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereb��certi(y that I have read 2nd examined this applicalion and know the same to be lrue and correct. All provisions of laws and <br /> ordinances gove 'ig ihis�ype of�vork will be complied wilh whsther specified herein or nol.The grenting of a permit does not presume <br /> t oive a honl to vi ate or cancel the provision of any other slale or local law regulating construction or Ihe pedorm2nce of <br /> co stru.tio i.T at I an uthorized by Ihe owner o(this property to peAorm the work for which application is made ar,d I comply vnth the <br /> Sta C nt cto Law 827 RCW and 296.200 WAC. <br /> , <br /> _ `�e —�u <br /> Signalur ot OwnedConiraclor orized Agent Date <br />