Laserfiche WebLink
PtRMIT APPLICATI(��� <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 /> I APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM � �9 �O� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# �J, <br /> 1J�,L' �i�w ��r� . � . : � _. � �� %— ��� � <br /> LEGAL LOT NO. �� BLOCK TRACT OR SUBDIVISION# , <br /> DESC. � ,yl c/ J I�/�. :✓ '� J; �, f •, <br /> OWN[R ADDRE55 CITY/ZIP PHONF <br /> :/i-_ � <br /> l r� ' <br /> / . _. 1, �' . f Oi� . _Y' 6 /✓> <br /> /,�.. . ��- ./ r �>� � ,� w� Y. � . , . ; ,�.^ <br /> TENANT NAME " CONTAC(FOR PERMIT PHONE y,J- 16p -�}:l ] <br /> �"�i:lh�' C� r.19nr e-Mna� ��.,��� �_4. j�',f �.:.•�� <br /> CONTRACTOR �. ADD ESS � CITY2IP PNON <br /> �_+,.iic. _ <br /> CONTR.LICEN581i <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> � �2 _Eleclrir, y`Gas_Olher .,Q 7-, � �, <br /> ,.��;-L,, <br /> WORK DESCRIPTION <br /> ' {;r��r ` '��l �i�� / ~ �� MECHANICAL <br /> PLUMBING <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE Of FIXTURE OR ITEM <br /> Toilel NC-air handling unils <br /> � Bathtub _ Forced air syslems <br /> � Lavalnry(wash basin) � _ vas pipir.g <br /> �_ Shower _ Water heater <br /> _L Ki�chen sink 8 di�sal _ Gas fireplar.e � ;� �h�„� <br /> L Oishwasher Gas range �a <br /> / Clolhes washar . � Clolhes dryer ',,v - � <br /> Walcr heater � Range hood � r/ ,` � <br /> � Sink(servicelbadmop/elc.) IG�-n•��"'� � Ezhaust(an n a � �� �� ���� <br /> ' Backflow preventer # _ Heat pump . J ` �1 �y <br /> � Urinal i _ Unilheater !t� � � <br /> Drinking Founlain � _ Boiler J� ,�.(� <br /> Floor drain Refrigeralion <br /> Gre2se Irap _ Woodstove <br /> Rool drains Other <br /> I yf� Olher �r , t''r .i�.•=,l I.. _ <br /> V <br /> CITY OF EVERETT LOCAL SA�ES TAX CODE IS 3105 <br /> II hereby cerili(y Ihal I have read and examined lhis application and know the Same to be true and correct. All provisions of laws and <br /> ordinaces goveming lhis lype o(work will be complied wdh whelher specified herein or not.The grantinq ol a permil does not presume <br /> to c�ive aulhority lo violale or cancel Ihe provision of any other stale or local law regulating construclion or the pedortnance of <br /> � conslruction. Thal I am authorized by lhe owner of this property lo perform Ihe work(or which application is made and I comply with Ihe <br /> �i Slate Conlractors Law 1827 RCW and 2962001VAC. <br /> � � � � <br /> , :� • ._� �. ..,�. <br /> ' '��-�.-, ,. ,. -�•���;_��� ' � . <br /> I, Signaturo ot Owner/ConlracbrlAuthorized Agenl Dato � <br /> I _ -- - -- �` � <br />