Laserfiche WebLink
F �RMIT APPLICATI�vN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �, -Ob-�S <br /> APPLICATIONS ARE ACCEPTED FROM 8 Ah� TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.O.# PE MIT#/- <br /> I��OS �Oc� rz z CL �I <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDf2E5S CITYIZIP PHON <br /> 1 ��21 co�-C��( /�v,�, �nitY 4C-,¢ct�DT <br /> p2�Vtp�lcC (",EDICAL CLT1��. �Y�(L�T q624(o L2S) 2(cl-'-�089 <br /> TENANT NAIJIE CONTACT FOR PERMIT PIiONE <br /> t� ,c� ST� �[a.C-c�R <<4"LS) 3`-4 � -0601 <br /> CONTRACTOR ADDRESS C17Y/ZIP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��S��J� p'� �Electric '�Gas_Olher <br /> WORK DESCRIPTION <br /> ��1�'U G.�-i l p�-J <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> Balhtub Forced air systems <br /> Lavatory(wash basin) Gas plping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink (service/bar/mop/etc.) Exhaust(an <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Re(rigeration <br /> Grease lrep Woodstovo <br /> Roo(drains Other <br /> Other <br /> CI7Y OF EVERETT LOCAL SALFS TAX CODE IS 9105 <br /> I hereby centify lhat I have read and er.amined this application and know the same to be lrue and correcL All provisions o(laws and <br /> ordinaces 9oveming this type of work will be complied wilh whether specified herein or not.The granting of a permil does not presume <br /> to givo authonty to violate or ca cel lhe provision of any other slate or local law regulatinG consiruction or the performance o( <br /> construction. Th t I am authori�d by the owner of this property to perform the work for which applicaliun is made and I comply wilh lhe <br /> Stalo Co / Law 18.27 R�W and 296.200 WAC. <br /> , �1 �j O�� i <br /> Signatu e o(Owned � uthonze Agent Date � �I <br /> I <br />