Laserfiche WebLink
PARCEL TAX I.D. # <br />PERMIT M <br />LEGA LOT NO. <br />BLOCK <br />TRACTOR SUBDIVISION R <br />DESC. <br />OWNER ADDRESS CITYIZIP PHONE <br />__ / ;v' y3Z�1 <br />fn 'l Jr 5 J�' / �v t : /{� j A V'C n 'SJ Gl - 3 f o 2 <br />TENANT AMECrONTACT FOR PERh11T � 0�� J, a 3 4 p <br />^^ <br />/`1 n l-f • i' E-MAIL MPt <br />_ <br />_UORTRTUTTOR— ORS CITY/ZIP P <br />CONTR. LICENSE p <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />/ Electric Gas Other <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink &disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />C!otlies washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />BackOow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease Trap <br />Woodslove <br />_ <br />Roof drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cert'f}jthal I have read an examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances,�overning this type 9 work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or c ncel the provision of any other state or local law renulating construction or the performance of <br />construction. That I am auth �i%d by tf)e owner of This property to perform the wo�. for which application is made and I comply with the <br />State Contractors Law 1A. �12CW an 296.200 WAC. <br />I J/ D oZ <br />Sign6lure of Owner/ ntrecto uthorized Agent ale <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.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />COry� <br />1 <br />SITE ADDRESS C/ <br />