Laserfiche WebLink
p�RMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everet;wa.org <br /> � � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ITE ADDRESS PARCEL TAX I.D.# P IT# <br /> ,� � � k; y:�� r 12� o�� � lr--�,��, -� z- �� -ZI <br /> LEGAL OTNO. BLOCK TRACT <br /> DESC. � C,� « t��,-l•Fr sn�-{ f,,,ld�;✓:,;,;.., � I:c2 — lG�-v.= <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> �l�K �r�c��n S.n /lf9/U y'(d'�/I✓t G�f/ �io2 � nnW.v.1� `/Lf77J` `/lf"�/ <br /> fJ C ���o)[ <br /> TENANTNAME CONTACTFORPERMIT PHONF <br /> ,. . . � � ',': �<- . . '' ,� r, yLz s�r�r, <br /> : �'C'�' ��rr . • 1` �� � <br /> � ' i <br /> CONTRACTOR ' .E L—„uC':�Jr:i�r 5..� ADDRESS ' CIN21P PHONE <br /> `, - . �� i ��o a���.� �v �,uZ . .�� a�r ��rr� <br /> CONTR.LICENSEp���EN�-FC��Y.�4T�.:�. � •t1' Z� �, , .. .4� j ' �g �, �, � <br /> . L.�.�nu/o:C 9fc')G <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S F� Eleclric ��Gas Other i � <br /> — — ��r/G,� _ <br /> WORK DESCRIPTION <br /> ��,� J��,-�t� N��� ; �� ���,c, I�P�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 3 Toilel A/C—air har .iling unils <br /> _2 Dalhlub � Forced air sys�e^s <br /> �_ Lavatory(wash basin) _` Gas piping <br /> Shower ___[__ Waler heater <br /> / Kitchen sink&disposal � Gas(ireplace <br /> � Dish�vashcr ' Gas range �� <br /> � Cblhes washer � _L Clolhes dryer . <br /> / Water he2ler � Rangc hood <br /> Sink (serviccibarimop/cic.) �'3i Exhausl fan <br /> Back(low prevenler Heal pump <br /> Urinal '%; _ Unil healer <br /> _ Drinkinc� Founlain : O� ' � Boiler <br /> Floordrain � � �- r�" Refrigeration <br /> Grease Irap �,� � _ Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y thal I have read and examined this applicalion and know the same lo be irue and correr,L All provisions of laws�nd <br /> ordinaces goveming lhis lype of work will be complied with whelher specified herein or noL The grantinc�of a permil does nol presume <br /> lo give aulhonty to violale or cancel Ihe provision of any olher stale or local law reguiating consiruclion or the performance of <br /> wnstruclion.That I m authorized by the owner of this property lo per(orm the work for which application is made and I comply wilh the <br /> S onlract 8.27 RCW and 29G.200 WAC. <br /> , <br /> ` /L � <br /> Signature of Own� / tractor/Authorized Ac�ent � Daie � <br /> L <br />