Laserfiche WebLink
FROM :Evergreen State Heat 8 Al" FAX NO. :4252596660 Nov. 19 2009 04:01PM P1 <br />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.or4) <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />Z11 IS OU�Ci�CC«?i a <br />I It OAS it - oaO <br />LOCAL LOT N0. <br />BLOCK <br />TRACT OR SUBDIVISION 0 <br />DESC. <br />OWNER ADDRESS CIT77—zIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />EMAIL <br />CONTRACTOR—F <br />6'kvuG'�c� 5 79irs /FflS ~�ICc �j <br />CONTR. LICENSE I2Q �/J'C/.�1G�9('r Fy- ry^70 / <br />p .� <br />67Z-La2G55 z9,;?.; vT <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Ar3/Q1-?v 77 4- <br />I <br />Electric .C]Gas_Other <br />I <br />WORK DESCRIPTION <br />cAl,nGe va%- Gft s ci9��c <br />- <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C - air handling units <br />_ <br />Bathtub <br />Forced air systems <br />(wash basin) <br />Gas piping <br />_Lavatory <br />Shower <br />_ <br />Water hooter <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dlshwashor <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />�. <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow proventer <br />_ <br />Heat pump <br />Urinai <br />Unit heater <br />Drinking Fountain <br />Bailer <br />_ <br />Floor drain. <br />Refrigeration <br />Grease trap <br />w <br />Woodalove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby codtlfy 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 typo of work will be compiled 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 stale or local law regulating construction or the performance of <br />construction. ThoU am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Cont ors Aw.18. CW and e.200 WAC. <br /><� <br />�q �D <br />Ig ure of wnor ontractor uthorized Agent Data <br />