Laserfiche WebLink
� PERMIT APPLICATION I <br /> 'I CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810-FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS �n � � , PARCEL TAl(I.D.# r , PERM��a ` 2 I <br /> �, % V <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESQ y <br /> OWNER ADDRESS CITYRIP PHONE ��V_��y� _ <br /> ���5��v�.�. �'1 Cc�lw�,h,� �'��� ��tca�r���' a.��- �� �'�3 � <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> �k�,�q,� ffW C�zl � �f'�1-`' �J�� �3�✓ -��� (� ' <br /> CONTRACTOR����y ` ADDRESS CITY2IP PHONE <br /> � �-rV, 1��Io �(t�'n� C I /— �0-�3�-17�k, <br /> II ,� �1- �'1(_y� � //�� <br /> CONTR.LICENSE p�,��A'�I�/� . �'a ��� ( J.�`� ' I' '������ <br /> 'y � � �"f �+'! � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK , <br /> � ( _ � Electric Gas Other <br /> .��{�l � LL�17U�'t'11 �� �C�.S � - - !� <br /> WOR DESCRIPTION � <br /> �i'�;)`�l�(% �i�7j�2� �ti�u�� ��1 J' ��'I'lr ' � ��� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> � Toilet A/C-air handling units <br /> � Bathtub Forced air systems i <br /> I _ Lavatory(wash basin) � Gas piping <br /> Shower _f_ Waterheater <br /> IKitchen sink 8 disposal Gas lireplace i <br /> I Dishwasher _ Gas range <br /> Clothes washer Clothes dryer , <br /> Laundry tray _ Range hood ' <br /> Sink(service/badmop/etc.) __ Ezhaust lan , <br /> Backllow preventer _ Heat pump �, <br /> Urinal _ Unil heater <br /> _ Drinking Fountain Boiler <br /> �� Floor drain _ Relrigeration <br /> � Grease Irap _ Woodstove I <br /> , Rool drains __ Other_ <br /> Other <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I� I hereby ceritify that I have read and ezam�ned this application and know the same to be true and correci. All provisions of laws and <br /> iordinaces goveming;his type o(work will be complied with whether specified herein or noL The granting ot a permit does not presume <br /> lo give aulhority to violate or cancel the provision ol any other state or local law regulating construction or the pertormance of <br /> I construc ion.That I am authorized by the owner of this property to perform the work for which application is made and I comply wiih the <br /> � State C itractors Law 18�7 RCW�nd 296.200 N'AC. � <br /> �., 0 3 v <br /> ignat re of OwnedContractor/Authorized�gent ate <br /> �- - - -- - - -- - -�- -- — — <br />