Laserfiche WebLink
`:�ERMIT ApPLICAl iON <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 - DEBIT& CREDIT C.4RDS ARE NOT ACCEPTED <br /> SITE ADDRESS ^ PARCEL TAX I.D.# PERMIT# <br /> ..�II/� ��, t/�L Y - !`'�� ��� l <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> ��'// /�.SY/Ytf1.�✓ �'��' �o�L ��/�Y !�/-Gr��,F,t-U/ yy5-::-s�- p��d' <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � <br /> CONTRACTOR ADDRESS CITY2IP PHONE � <br /> bd�� .ti✓L%Lp�r���Rvdf7 foQoxlOy/ �ti�i1'T✓�d� 9Jhd 7r� y�s-3�f-G�I_� <br /> ICENSE# <br /> /? J 'h'NS 9 70.O1✓ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � <br /> �� ',/�,���� _Eleciric _Gas_Other 3��U,D� <br /> � �r <br /> WORK DESCRIPTION ��},G'O � <br /> PLUM[31NG MECHANICAL <br /> NO. TYPE OF FIXTUt:E OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet 4/C—air handling units <br /> BathWb Forced air systems <br /> Lavatory (wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas freplace <br /> Dishwasher Gas range <br /> Cblhes washer Cbthes dryer <br /> _ i _ Laundry tray _ Range hood <br /> I _ Sink(service/bar/mop/etc.) = Exhaust fan <br /> BackFlav preventer Heat pump <br /> _ Unnal Unit heater <br /> Dnnkin� Fountain Boiler <br /> Floor drain Refrigeration <br /> � Grease trap \Noodstove <br /> Roof drains Other <br /> � Other <br /> CI1Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and kno�v the same to be we and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with�vhether specrfied herein or rot The granting of a permd does not presume <br /> ro give authority to violate or cancel the provision of any other state or local law regulating conswction or the performance o( <br /> construction. That I am authorize by the owner of this property to perform the work for wnich application is made and I comply with the <br /> Slate �omractor,��Law'(�.2]RC�Jd and 296.200 WAC. <br /> � ,�� <br /> -� :s'�;/,(',,l,'N✓,!'h � — <br /> �Signature of�t wner,Contrac,ouAuthonzed Agent Date <br />