Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 Spy Wo(P a-p( <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />`` 1 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM !Vp �OLrA�r m <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT 0 <br />1,) 1 :1 <br />U! I lUno tt-1•1C <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. LI( -f2 Ick(ic� <br />k�l% . <br />OWNER ADDRESS CITY2IP PHONE <br />> l)R d bjor�r Rai S I Iy'S CJ %III f<I I+ i�zV l Fes(: •tL 9°<' s (47 '- SS;- Gd�2 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />T+cX' 4?� 7-?S-Ssco <br />CONTRACTOR Plch„el Po4U-)es'E. ADDRESS CITYIZIP PHONE <br />18`!c5 g4ahAUCi, ILf.t,64,''A 980?2 4as-ZSI-4?SiS <br />CONTR. LICENSE# Ni [c�G(,�r'1 (� �/ICI{ <br />USE OF BUILDING I <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />CY. Fa-.. (y I <br />_Electric _Gas —Other <br />rFl� 7 ACC <br />WORK DESCRIPTION <br />S(opC 10e, I I'z `/'� I'rles L� L&99.Z, y -! <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C - air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />_ <br />Water heater <br />_ <br />Kitchen sink & disposal <br />_ <br />Gas fireplace <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Laundry tray <br />_ <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backfiow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />_ <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boiler <br />_ <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodstove <br />_ <br />Roof drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritity that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of 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 the performance of <br />construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Stale Con clors Law 18.27 RCW and 296.200 WAC. <br />Signature of Owner/Contractor/Authorized Agent ' Date <br />