Laserfiche WebLink
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 <br />PARCEL TAX I.D. # PEqMIT# <br />LEGAL LOT NO. <br />nBLOK <br />,5 <br />TRACT(�DESC.� <br />YJGC /clef.✓ �GCGI" <br />OWNER ADDRESS CITY/ZIP PHONE <br />bd; , V 4''I✓.'; Aend z /-3,Y i /\/, Q <br />TENANT KAME CONTACT FOR PHONE <br />�PERMIT /J <br />PL�I VG.✓L SIycI� yZ�-OZor/I1Iz <br />CONTRACTOR V I vN /` `lam ADDRESS CITY/ZIP PHONE <br />i r �Ssocr471�s W( Po. +4Dx 13066 Et'4'-4tj' 6)006 <br />CONTR. LICENSE # �I ZS e—, , .,- <br />I/aNS�Tc�z� n v <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />I <br />Electric Gas _ Other <br />WORK DESCRIPTION /;1 7�0 <br />.� frU/v <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />NC — air handling units <br />_ <br />_ <br />Bathtub <br />Lavatory (wash basin) <br />Y <br />Forced air systems <br />Gas piping <br />_ <br />Shower <br />Water healer <br />I <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />_L <br />Gas range <br />_ <br />Clothes washer <br />Water healer <br />—� <br />Clothes dryer <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />_ <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 />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 I am authorized by the owner of this properly to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 CW and WAC. <br />760 <br />Sign?JUre of Owner/Contractor/Authorized Agent Dale <br />IL <br />