Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT S�FtVICES <br /> 3200 CEDAR STREET, EVERETT, W<� 913201 <br /> 425-?57-8610-FAX 425-257-8857 -www.¢�verettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS �j�`.;L J ��.�,p�((��� PARCEL TAX I.D.# P�BMIT k,I� I � <br /> % /1 �Y <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER � ADDRESS CITY2IP PHONE��S_ �J9-.�,�'19 <br /> J�(�tc,tz ��c�2o-ze4�,r/ <br /> TENANT NAM1E CONTACT FOR PERMIT PHON� <br /> �: i�L 'O ���-� �n.-/cCli� �-�^�� �aS-.�55'- !l4/�� <br /> � <br /> CONTRACTOR A�CRESS CITY2IP PHONE y�7_;,ss-ysiS' <br /> EC�.zj�:..�C�.64��a��� �GioE���u�,�uh� �.�<<z� <br /> CONTR.LICENSE# �`Y <br /> Z��c• `7,�'�oJ' <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICG OF WOP.K <br /> ��q/ _Electric XGas_Other '�3�3�. � <br /> WORK DESCRIPTION /'' . � i� , � � it <br /> 1.���.(+12.�� �� c �1�t .�ctr.-c <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower _ Water heater <br /> Kltchen sink&disposal _ Gas freplace <br /> Dishwasher _ Gas range <br /> Clolhes washer _ Clolhes dryer <br /> Laundry tray _ Rangehood <br /> Sink(servicelbar/mopletc.) _ Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Reingeralion <br /> Grease lrap Nloodstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3705 <br /> I hereby ceritily ihat I have read and examined this applicalion and know the san-��to be irue and correct. All provisions of laws and <br /> ordinaces goveming this type ol work will be complied wilh whether specAied herein or not The granting et a permit does not presume <br /> to give auU�orny to violate or cancel the provision ol any other state or local law regulating construction or the pertormance ol <br /> construction.That I am authorized by ihe owner of Ihis property to pertorm the���ork for which application is made and I comply with Ihe <br /> State ConLactors Law 18.2�RCW and 296.200 WAC. <br /> J .� . / <br /> i -!..'i.-+= 'i'f��•../��: %C•.i/- t/ <br /> ignature ol O�medComractor/AuthonzeA Agent Date <br />