Laserfiche WebLink
�- PEF�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982C1 <br /> 425-257-881 G-- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PER��D� <br /> /'' i0 h'Kc�:2.,- �[/n - Lb�'B SY z/�1 D Z/ 00 /� - 7 <br /> LEGAL LOTNO. BLOCK TRACT n c �J, <br /> DESC. j � �.� �` L Z J L� /i/�I LC' S /i7D Y-O [=✓P/Y f! <br /> OWNER ADDRESS CITYIZIP PHONE <br /> C�1c�OWi� k � ��l ✓� /D/� RI.Cc�'2r Ei.c.pfi� Lt�'h' <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> (O W � r� _J4►�e, M i�c�•c �� yZs '7SY Ss-z8 <br /> CONTRACTOk ���� y�G��D�L ADDRESS CITYIZIP PHONE <br /> �� 9s33 EAs+vrcw �v� L��'r.-�} �lzt ?ry ssZg <br /> CONTR.LICENSEp CVE �EA LO `^�� I�LOPj <br /> F— K- / <br /> USE OF BUILDING HEAT SOURCE /JC I EAT CONTRACT PRICE OF WORK <br /> c3lA ✓L �(�I� � laA2fiGF o <br /> �Eleclric �Gas Other � 30� 0 d <br /> WORK DESCRIPTIO!: ������ r,� � S 4 ;`�a' �n.c.;,+x y� S �Rb � �t�ik�i �p NPM/ �u���� <br /> � ar��+ U� <br /> �y y� � �.�, i� �,,� . ��� ,��, <br /> PLUMB�NG MiCHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toiiel A/C-air handling unils <br /> OalhWb Forced air syslems <br /> Lavalory(wash basin) _ Gas pipinc� <br /> Sho�ver Waler healer <br /> Kitchen sink 8 disposal Gas(ireplace <br /> i Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water healcr Ranc�e hood <br /> Sink(service/bar/mopletc.) Exhausl(an <br /> BackOow preventer Heal pump <br /> Urinal Unit heater <br /> Dnnking Founlain Boiler <br /> Floor drain Re(rigeration <br /> Grease trap Woodslove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVER2TT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify ihal I have read and examined this npplicalicn and know ihe same to be true and correct. All provisiens ol laws and <br /> ordinaces governing lhis type of�vork will be complied with whether specifed herein or noL The granting of a permit does nol presume <br /> lo give authority to viola;e or cancel lha provision o(any other slate or local law regula�inc�construclion or lhe periormance of <br /> conslruction.That I am authorized by Ihe o�ener of this property to periorm the work(or which application is made and I comply with the <br /> Stale Con�aclors Law '8.27 RCVJ and 7.9C�.200 WAC. <br /> -=� i ,��r--�l�/ 3� /ob <br /> Sig lure ol OwnedCon'.ractor/Aulhorized Agent ale �/ '� <br />