Laserfiche WebLink
�1 • <br /> I ^ PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � __ r. <br /> 425-257-8810-FAX 425•257-8857-w�nnveverettwa.org <br /> i,� _ _�_J APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM 'a �"as�I U <br /> PARCEL TAX I.D.q I PERMIT k Z <br /> SITE GODRESS ` n/"L�O� �Q�J <br /> ( ta0 � U.�e. �° Oo � <br /> LEGAI. LOTNO. BLOCK TRACTORSUBDIVISION7t <br /> CESC. <br /> OW HER <br /> ADDHE55 CIT'(1ZIP PHONE <br /> �l0 00. V.�c S�- OC �-A , C u y,.t� G� f?,o!03 ��5 � `a�`53� o�J`a b <br /> lENANT AME I CONTACTFORPER(�MI�T PHONE (��, �y�� �I�� <br /> �(YV Z (17 L7 uL1V�'�� E•MAILY�IY1,1 Z�%U� '�.1'� <br /> ADOHESS �jII�CI � GIiYlZIV �HONE ��/� • <br /> l. N1RAl:iOR •�,{�110�f1 ' � P` �i;'-�1� r �,� ,�a�: y�1C (•Cil <br /> n �04�C+G <br /> CONTR.UCENSEII (�C ���\1A'"1�1 �i ' <br /> �� I CONTRACT PRICE OF WORK <br /> USE OF BUIL�ING I HEAT SOUF.CE <br /> � � �Electric Gas Other � �� <br /> WORK DESCRIPTION 1 1 � <br /> � �`(���`��\ ��C.�1�� '� J �9�-� �� <br /> PLUMBING MECHANICAL <br /> NO. TlPE OF FIXTURE 071TGM <br /> NO. TYPE OF FIXNRE OR Il�[M <br /> IToile� _ .vC—air h9ndling uni15 <br /> ^ Bathtub _. Forced a�r systems <br /> I � Lavalcry(wash basmJ = Gas pipin9 <br /> Shower VJatrr heater I <br /> KAchen sinl:8 disposal Gas firepl�ce <br /> O�shwashcr _ Ges renge <br /> ClOthns waRhe� _ Clolhos CryM <br /> Woter heater _ Range hood <br /> S�nk(,crvice/badmop/ctc.) Ex��aust lan <br /> Backnow oreventor � Heat pump <br /> � Urinal _ Unit heale� <br /> � Dnnkmp Fountain _ Botler <br /> � � Floor dra�n _ Rehigerotron <br /> Grease irap ._ Woodsto�'e <br /> Rool drains Othcr <br /> Othe� — <br /> CITY OF EVERFT7 LOCAL 3A1E5 TNf CODE IS J105 <br /> i hereby eenify ihat I heve rcad and examined this applicabon and know the same to be true and wrrect. All pmv�sions of laws an0 <br /> oNinancns goveming t�is typo oi wOrk will be compli9d wilh wheL'�er specd�ad he�ein or not The grantng of a pem+it dces nol pmsume <br /> to grve aulhority to�olate or cancel the Drovision ol any other 5ta1C or lotal law regulaUng conStNctlon or the perforci�ance ol <br /> wn3t7 clion. That I am author¢ tl by Ihe rnvner ol this proporty to PeHorm the work for wh�ch opp��cation�s made and I cumply with Ihe <br /> 5(ale ontraaors law i8.27 and 2 200 WAC <br /> , <br /> ' � �� a...� �-- <br /> L� <br /> 3� ature o wne��Contract r! u �onzed Agent <br />