Laserfiche WebLink
ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810— FAX 425-257-8II57—wuw�.everettwa.org ' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1�')..J/(� <br /> SITE ADDRESS PARCEL TAX I.D.# P�E I # <br /> ��3Z �`�1 t.� ST. F�/E/�€�f, Wh On438�az ba � bo I I ( i��Z�� <br /> LEGAL LOTNO. BLOCK TRACT <br /> oEs�. � a ZZb <br /> OWNER ADDRESS CITYIZIP PHONE <br /> L�= 7u j-�Na 1132 Hnr�€ srp�'f, 6v�a�rr, wa ��zal (µ'tjlba. "bol <br /> TENANT NAME CONTACT POR PERMIT PHONE <br /> N/ir Tsc ,tw� r�rf l�tz�f:�Z-�s�s <br /> CONTRACTOR 0���� ADDRESS CITYIZI PHONE <br /> CONTR.LICENSEp C�(%�"w�� ^'""�'�••�� <br /> ����� - <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> s��l71�+- �N��7 �Eleclric _Gas_Olher � I D 0,O�v. � <br /> WORKDESCRIPTION s��� '�H��1' �}Ou.lE J}A�I'T�0�1 � ��'� 2- SToFY �9w� <br /> I <br /> oF $zB s.F. . Nf�,r �nc�r.o� �- ��'6� s�. � ¢�a s•f. o�` Gik�yt� -f 310 s.F �f r-i��NG� (o <br /> Fl,�o� ; �4�' sF. c� r,.;N ��ow . ( �F3°s�, op �na,r•�e � ►,r��'�� oF c;..;�.> <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> [. Toilel A/C-air handling units <br /> � Bathtub Forced air systems <br /> � - Lavalory(wash basin) Gas piping <br /> _I _ Shower _ Water healer <br /> Kilchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Wator healer Range hood <br /> Sink(service/bar/mop/etc.) � Cxhausl fan <br /> Backflow prevenler Hrat pump <br /> Urinal Unil healer <br /> Drinking Founlain Boiler <br /> Floor drain Re(rigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA7(CODE IS�705 <br /> I hereby ceritify lhat I have read and examined Ihis application and know the same to be irue and correct. All provisions of laws and <br /> ordinaces governing this type o(work will be complied wilh whether specified herein or n it.The granting of a permit dces nol presume <br /> �o give aulhority to violale or cancel the provision ot any olher state or local law regulating construclion or lhe peAormance of <br /> wnslruction.That I am aulhorized by the owner of this property to peAorm lhe work for which applicalion is made and I comply with lhe <br /> Stale Contraclors Law 18.27 RCW and 296.200 WAC. <br /> Y�� L�; ��'�i ��°5 <br /> Signature o(Ow edContraclor/Aulhorized Ac�ent Dale T <br /> ( " <br />