Laserfiche WebLink
P�.r�MIT APPLICATIG�J ���� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �2/ <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# P�RMIT# <br /> � 1 � �! �� d y •.'- .�y - �d9- � %5 Sa/� i `� <br /> LEGA LOT NO. BLOCK TRA . % , i�n �� / 3 <br /> DESC. G�'��D / �� . , r� � <br /> OWNER cf\���5 �tW.� (�V�{l �?.�'Z �f'�7i �i'1�R�� • N�LIK-II7�-�IVOI. C1Sd�l�P��7i-3SSH�4C'/ �^ <br /> / i .�r�t—��i CJG�--r---+�`r�1��� r� Nl1 - 1 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACTOR /.1/�S' Ll�,���c��� ADDRESS 5 j�j`�i�,��`�cmmP�� PHONE �'2S_ �S�_�3 G <br /> / <br /> CONTR.LICENSE# ��,S� OCx �1GG�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S/q��; /k"nl��f _Electnc _Gas_Other � 1� DGU d0 <br /> WORK DESCRIPTION C."�'7L:�f�/j ny ,�2 Ll�k� �rl / G��cc,i� `r7 .�iCm4`2�1�1'�Y G7LL <br /> ��tCl w �f �,�-���,��r�� ��,c �ti<<��C' !� c�d� �r� G���'�am . <br /> �yJ'1 S7`G-CL <�1�/',i�, l� L % �. 1 L ' - <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. IYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling unils <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Re(rigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> i — — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this applicati�n and know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether specified herein or not.The granting cf a permit does not presume <br /> to give authority tc violate or cancel the provision of any other state or local law regulating conslruction or the performance of <br /> � construction.That I am authorized by the owner of this property to peAorm the work for which application is made and I comply with the <br /> State Co tractors Law i827 RCG and� .200 WAC. <br /> I �L..�...1//�/'%/i /�lL//JY/GC' �//�/ !US <br /> Signature'of OwnQYlContrac or/Authonzetl Agent �—' Date <br />