Laserfiche WebLink
P�RMIT APPLICATI(.►N <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 /> ,f <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PAN -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.p ERMIT# ? <br /> 7' � fa v i C7Ol��J�oOCX7tiC� SC50 ' J <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. ��_�( � � <br /> �� <br /> OWNER ADDRE55 CIN21P PHONE <br /> ������-�cZ -T, -'l_SLS�T w.t.vT � .2cx.� i_�— �- � �.tu��1 w`\ � <br /> h cx2�T <br /> TENANT NAME CONTACT FOR PERMIT PHONE � <br /> I LF1 rr� �G: e� �( z5-75�--�toE36 <br /> CONTRACTOR ADURESS CIN21P PHONE <br /> CONiR.LICENSE N <br /> USE OF BUILDIYG I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> I _Electric _Gas_Other <br /> WORK DESCRIPTION <br /> �a `".�� ��c i S`t \%.� l-�O c_tiS� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FU(TURE OR ITEM <br /> _ Toilet A/C-air handling units <br /> _ Bathtub Forcedairsystenu <br /> _ Lavalory(wash basin) Gas pipinc� <br /> _ Shower Waterheater <br /> _ Kitchen sink&disposal Gas firepla,:e <br /> _ Dishwasher Gas range <br /> __ Clothes washer Clolhes dryer <br /> _ Lavndry tray Range hood <br /> _ Sink(service/bar/mop/etc.) Exhaust fan <br /> _ BackOow prevenler Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Foun�ain Boiler <br /> _ Flcordrain Re(rigeration <br /> _ Grease lrap Woodslove <br /> __ Roo(drains Olher <br /> Other — <br /> CITY OF EVERE'.T L OCAL SALES TFU(CODE IS J105 <br /> I hereby ceritify that I have read and examined this appiication and know the same to be We and correct. All provisions of laws and <br /> ordinaces governing this type o(work will be complied with whether specified herein or not.The grantiog of a permit does not presume <br /> lo give authority to violale or cancel the provision ol any other stab�or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner ol lhis property to perform lhe work forwhich application is made and 1 comply wilh the <br /> State Co�act�r Law 18.27 RCW and 296.200 WAC. <br /> r/ (/�� �,.y <br /> / �%� VJ-�� vlJ�� <br /> Signalu �o( wn JA.onLacror/Authonzed Agent Date <br />