Laserfiche WebLink
PE`�.MIT APPLICATIOh <br /> CITY OF EVERETT PERMIT SERVICES �°G ��_c3� <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 �'/'�y � :% � � <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT A ��_ <br /> ) .'�-,.n-,-�— � <br /> I �1;�L� ''��" 6��' ��:G� V�7`I /7 LL°L'L� �.�,�'(.�.� _ �--�'^_ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. ZU <br /> OWNER ADDRESS CITYIZIP PHONE <br /> ���I Ilti �S(•��Cy ���1�� �,';f illri'. 5, r �U2('d��Y 9� ZO:S� ,?cr- �iiY�S/s�' <br /> TENANTNAME � CONTACTFORPERMIT PHONE <br /> JeS-x 13-�}orr� �'L`d- .75S-5,s�7 <br /> CONTRACTOR ADDRtSS CITY2IP PHONE <br /> 5�k Len�.�lfvif,�� 7 q <br /> CONTR.LICENSE# � II���I L l�C,j L„�iL� /ho)��I ���L� �J� �IS��-75 yZ�' ��C'��LLI3 <br /> �Lf�C ,'��OEC•Or r <br /> USE OF BUILDING HEAT SOURCE CONTRAC ICE OF WORK <br /> � �7r � <br /> L " I Eledric _Gas_Other �=� ��� �, <br /> f�<<>>i Ei1���C <br /> WORK DESCRIPTION , <br /> � <br /> QiM:c,'.� �f[F>I;.i.'nx'i1f c� �J�. `•�' ��9c`��` �i5i�'y•� G'lr, Kcin:.:d 4�e�l�r.' C ..m_iJer Gi✓l3 • <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavato�y(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposat Gas fireplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Laundry iray f Range hood <br /> Sink(servicelbarlmopletc.) 3 Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Soiler <br /> Floor drain Refrigeretion <br /> Grease Irep _ Woodstove <br /> Roof C•ains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify 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 grenting of a permit does not presume <br /> to give authoriry to violate or cancei the provision of any other state or tocal law regulating construction or the pertormance of <br /> construction.That I am authorized by lhe owner of this property to perfortn the work for which application is made and I comply with ihe <br /> State Contractors�l.�aw 1827 RCW and-296200 WAC. <br /> r <br /> ` � �J �C- <br /> �` <br /> Signalure of OvmO�ntractodAuthonzed Agent Dale <br /> i / <br /> /�� <br /> � <br />