Laserfiche WebLink
i <br /> � P��RMIT APPLICATI(„� <br /> � CITY �F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 i <br /> 425-257-8810- FAX 425-257-8857 -www.everettwa.org � <br /> __ APPLICATIONS ARE ACCEPTED FROM 8 AM TO 3 PM S'_a.8.,�� I <br /> ----- <br /> � cITFA�J.^i?F...^" C� r>" — ._ � <br /> ��' PAi2CEL TAX I.O.# �-- <br /> �� ��1 {1I �� <3��b r PERMITif <br /> I LEGAL� I �' _ � � ':' .- �' ' �_'.1..� : ^ I O� ..� I� <br /> ` �j ._.—.r.�. � <br /> ln7 Np, � BLOCK TRACL�N SUBOIVISION q \'�' <br /> DESC. j��—� . <br /> i _ , . ._. - ' . <br /> OW�. `J : <br /> . . . : , ADDRES � CITY2IP PHOtlE ��— <br /> , . .. .. ��� .� � .• � , .: � '. .. ��7 <br /> I TENANTNAMG —_�'' �_ %� i _ . � , i - �' ' ' �i.i;_ . ' ... ,_� , i. <br /> I CONTACT FOR PERMIT .:�i : <br /> PHONE I <br /> i CONTRALTOR '�. .,;" ' �. . . _. . <br /> � <br /> E-MAII ��.; . r� � <br /> ' _- . . . . . . . .G�DRESS CI,�/ZIP PHO E � �� �.,..u—ti;�:� <br /> � COhITR.l.ICENSEif ` � � � .. j <br /> ;. , . � � .. . , . � .,� I <br /> USE OF DUILDING ��� �'`� � <br /> _ ` I ' HEAT SOURCE � I CONTRACT PRICE O— p yy— pR I <br /> ���� - _ Electric . �.. Gas_Other I , <br /> WORh DESCRIPTIOIJ .� ' I <br /> ,�L i <br /> - I <br /> _'---- -- � _ � , , - � <br /> PLUMBING '; � ` � I <br /> NO. TypE Of FIXTUR[OR ITEM MECHANICAL <br /> ,.. NO. TypE OF FIXTURE OR ITFM f <br /> 1 <br /> _,_,_ Toilr.l I <br /> '-- f3alhtub .� A/C–airhandlingunils I <br /> ��_ L�vatory(wash basin) � Forced air syslems <br /> ��_ Showr.r Gas pipinr� , <br /> ___ I(ilchen sink 8 disposal � Water hea�er j <br /> ___ Uishwasher .�_ Gas fireplace � <br /> _ Clolhes washer _/ Gas range � <br /> _ W�ter!iealer J_ Clothes dryer � <br /> I�__ Sink(service/barlmopletc.) � Range hootl i <br /> . � Backllow preventer _;i Exhaust fan I <br /> ` Urinal � Heal pump � <br /> _,_ Drinking I'ountain � Unit heater i <br /> . Ploor drain � Boiler <br /> _._,_ Greas�Irap �L, Refngeration I <br /> _ Roof drains ._. Woadslove <br /> __ Olhr.r _, Olher <br /> --- �— <br /> . CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> heret�}•cerilify Ihal I have read and examined this application and knoiv(he same to be true and wrrecl. All provisions of laws and I <br /> �rdinaces governing this type of worlc will be complied wilh whelher specified herein or noL The granling of a permit does not presume I <br /> �nsl ur.tioit Th,�l I am�authoiimd by�lhe ov.ner oF Ili s��operty to pertortn'tl e work for�.h ch applisalio ri f�made a d�l cromply wilh Ihe � <br /> �aia Conlral.tui� I_aw 1027 RCVJ and 29G.200 WAC. � <br /> 9naWic ql O�,vnr.dConlraclor/Aulhorized Agenl 5� � �'��� � <br /> Dale � <br /> -- --- ----- . <br /> -- --- _ ��Z i <br /> _1 <br />