Laserfiche WebLink
_ --i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 -FAX 425-257-8857-Nnvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM 7 —I�I �- O� <br /> SITI•ADDRESS PARCEL TAX I.D.# PERM4T B <br /> � -a o L % <br /> 190� n��_<% 1�< Uo ,�(�u�E�c:c, �- ls��i>D7 <br /> LEGA LOTNO. BLOCK TRACTOR$UBDIVISIONp <br /> oE��. �, oci i�c�r= Crr•����i Ass� I�n7 <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> � 4z5•a-�, .3��— <br /> �v�v��c (;,ecv�;a�.,v� 5U1 I.��nt� Vie���i� �nt+�r,N� Isu,�,� �,;<r.e� <br /> TENANTNAME I CONTACTFOBPERMIT PHONE,�-� >, � <br /> a3 £�>> 5�5�- <br /> ��SSc �jira��� e-Ma� 53i N<<•r i1h-�hU-F'N�T <br /> A T �$ �i9Pi <br /> NAtc �c�r,si�:ucT�eN _yij Flcw�n���� �.,cCit�� `ir'iCl ��.-5C'p� 43}(r <br /> CONTR.LICENSE# <br /> USF�F BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> J ��lL- <br /> ��1N({� nµ�ly �E�°�� _L=lectric ,�Gas__Other �' 2(L� '��fl C.� <br /> WORK DESCRIPTION <br /> �i�mcvc_ l�c'�iacc �cY,� < <u��T (xTc2iok' l,l;'�41�s �AInAr<<� (�.'� T �t� . <br /> �.�Ilk!�( � ��iPIf�CC �NZ(-LI(,i- �I�ll$hi '� . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> � Toilet ' ' NC-airhandlingunits <br /> � Ba�hiub /;;� � Forced air syslems � <br /> � Lavatory(wash basin) '!�� Gas piping <br /> Sho•rvcr _(_ Water heater <br /> ! � Kitchen sink R disposal _ Gas fireplace <br /> � Dishwasher Gas range <br /> Clothes washer � Clolhes dryer <br /> I __ Watcr heater . � � � Rangc hood <br /> � r�. Slnk(service/bar/mop'etc.) 1 � � � Exhausl fan �/ <br /> �ackllow preventer _ Heat pump <br /> Urinal Unit he�ler <br /> Drinking Fountain _ E3oiler <br /> Floor drain Relrigeration <br /> _ Grease Irap Woodstove <br /> i Roofdrains �. Olher �Ak��! v�V-t�1�t1�f�. <br /> Othcr <br /> CITV OF EVERETT LOCAL SALES TAX COOE IS J105 <br /> I hereby ceriti(y Ihat I have read and examined this applicalion and know Ihe same to be true�nd correct. All provisions ol laws and <br /> � ordinaces goveming Ihis type of work will be complicd with whether specified herein or nol.The granting of a permit does not presume <br /> to give aulhority to violate or cancel the provision ot any other stale or local law regulating constmc�ion or Ihe pedormance ol <br /> constmction.That I am authorized by Ihe mvner ol Ihis property to pedorm the work for which application is made and I comply with the <br /> Sla�e Conlractors Law 1827 RCW and 296200 WAC. <br /> �'7 = � .. <br /> �' �l �U <br /> SignaWr erlContractor/Authorized Agent Date <br /> � _--------- — -- � <br /> i <br />