Laserfiche WebLink
PtRMIT 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 <br />PARCEL TAX I.D. # <br />PE T # <br />LEGA LOT NO. <br />BLOCK <br />TRACT (� <br />4 <br />DESC. [,p .- (- <br />i <br />(ANT ftAL- f rl (L-r= 0I n t, rJ <br />OWNER ADDRESS CITY/ZIP PHONE ZSZ- 1y77 <br />�7 <br />i; u2' ( `ZA V-or�1 470U A1Afzy4i AJh J lV(EPLC-r1 37.0-5 _ <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />I`oay, i �r�k�vFv,^,y <br />I rL„r, _n ; rrw;'-p Lsi - r477 <br />CONTRACTOR U i`r v �JL ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric _� Gas Other <br />WORK DESCRIPTION <br />S rL... 0 ,V, ,<<, <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE 01: FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodslove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I Have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whe'her 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 stale or local law regulating construction or the performance of <br />construction. That I am a- Ihorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contractors Law 18.27 RCW and 296.200 WAC. <br />Signature of Owner/Contractor/ ulhorized Agent Dale <br />16 <br />