Laserfiche WebLink
� PERMIT APPLICATION <br /> CITY rJF EVERETT PERMIT SERVICES '�, <br /> 3200 CEDAR STREET, E\'ERETT, WO 98201 I <br /> 425-257-8810- FAX 425-257-8857-www.everethva.org I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE A�DRESS PARCEL TAX I.D.# PERMIT N <br /> 7 d'2$ U.�.aL'�..' /Z�OG•E ti'(� I �� G�GC c� -Li(�-{ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. +f <br /> OWNER ADDRESS CITYRIP PHONE <br /> /)J.e �a�tY.�Pa.�sc.-� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE �� <br /> COHTRAC70R �j,rJ{�rp/,SlJnJ II��y(�, . ADDRESS CITY2IP PHONE <br /> z433 �� ilvn. O�r,�� 3�v-v�3 'Yh � <br /> CONTRLICENSEI ROI�/N!�-�( Z��� t .�.•?t/NC-/i�,.. <br /> qb'2 z 3 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK � <br /> s r2 _Elednc _Gas_Other -?��� � <br /> WORK DESCRIPTION <br /> irvSiitu �'=�i2r S�i'�i..r�[c-a • /`' r�«. Srl� <br /> PLUMBING MECHANICAL i <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM � <br /> I <br /> Tcilet A/C—air handling units;� �, �, � - ' <br /> Bathtub Forced air systems <br /> ' Lavatory(wash basin) _ Gas piping <br /> � Shower Waler heater � <br /> Kitche�i sink&disposal Gas fireplace 'i <br /> _ Dishwasher Gas range <br /> Clothes washer Clothes dryer , <br /> Laundry tray Range hood '', <br /> Sink�servlcelbar/mupletc.) Exhaust fan <br /> BackOow preventer Heat pump � <br /> Unnal Und healer <br /> Drinking Fountain Boiler <br /> ' Floor drain _ RefngeraUon <br /> ' . Grease trap Woodstove <br /> Roof drains Other <br /> � Olher <br /> _ 1(Q N[�R�>j <br /> I <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 I <br /> I hereby cenidy that I have read and ezamined this appliwtion and know lhe same to be irue and corred. All provisions of laws ar.d i <br /> ordinaces governing this lype of work will 6e complied vnth whether specifed herein or not.The granting ol a pertnit dces not presume � <br /> to give aulhonty to violate or rancel the provlsion o1 any olher state or local law repulating constr�IXion or the pedortnance o1 � <br /> . construdioa That I am auihonzed by the owner ol this property to pertorm the work for which applicahon is made and I comply vnth the I <br /> i State Contractors Law 10 27 RC and 296200 WAC. i <br /> �--:;�\ � ti-� / <br /> I Signature of OwnerlContractor/Authonzed Agenl L 7 � �D e �;, \\v i <br /> �r. \,, I <br /> � ' <br />