Laserfiche WebLink
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 t? AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGA LOT NJ. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS p� CITYIZIP PHONE y j.,7)�1SlF <br />(tJ1LLtg1ti1 H01 E I"1AetNL-: vlrwL�I(Z, L,ev-e-rt AT)-ol _ <br />TENANT NAME CONTACT FOR PERMIT PHONE LIIf•�3s.2T%� <br />I ��(LL1 AW1 1�AV15 E-MAIL-AIL <br />CONTRACTOR ADDRESTS CITY/ZIP P E <br />CGNTR. LICENSE # Q)-),AQJ�" <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />(i )it'Z'OC �' is /C/iQ-?02-1 <br />_ Electric _Gas _Other <br />WORK DESCRIPTION <br />pLMD �A;LACTt / ene�—?•k-T <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toiler <br />— <br />A/C FVC —air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />—Gas <br />fireplace <br />_ <br />Dishwashe, <br />Gas range <br />_ <br />Clothes washer <br />_Clothes <br />dryer <br />_ <br />Water healer <br />—Range <br />hood <br />_ <br />Sink (servicelbar/moplolc.) <br />Exhaust fan <br />_ <br />Backllow preventer <br />—Heat <br />pump <br />_ <br />Urinal <br />—Unit <br />heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />_ <br />Other <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />hereby ceritify that I have read and examined This application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to viola'e or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Co actors Law .27 RCW and 296.2D0 WAC. <br />y <br />Signature o Owner/ ontractor/Authorized Agent Date <br />PERMIT <br />