Laserfiche WebLink
PE�.NIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-vnvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT# <br /> oq W�.�w�et2c'L tM-C35io •0!5 <br /> LEGA LOTNO. BLOCK TRACT <br /> GESC. <br /> OWNER _ ' !7 Q�y \ _ � AODRESS � �CI�T�Yn2IP�y� PMONE <br /> 'jW�i�,c�1/��5�- `_ Y�l�`'� �(� W� Cw�+"�-1.tiM L�''�-�!}-��7 <br /> - �� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACTOR �� �(LpA��.�tL ADORESS CITY2IP PHONE <br /> � �k�� 6F-o�'�� IZuYLVti�c �l�a-U� �i��t-b666 <br /> CONTR.LICENSE N <br /> ��\���� L�� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric �Gas Uther � �� <br /> WORK DESCRIPTION <br /> � N� ` <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet A/C-airhandlingunits <br /> __ Bathtub T Forced air systems <br /> Lavatory(wash basin) 1 Gas piping� K�+�IS�� <br /> Shower Water heater <br /> Kitchen sink&disposal Gas flreplace <br /> Dishwasher _ Gasrange <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Unnal Unit healer <br /> I _ Drinking Fountain Beiler <br /> � _ Floor drain _ Refrigeration <br /> Grease trap Woodstove <br /> _ Roof drains Other <br /> Olher <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> ' I hereby ceritify that I have read and examined this application and know the same to be irue and corcect. All provisions of laws and <br /> ', ordinaces goveming this type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> Iro give authonty to viofate or cancel the provision of any other state or local law regulatlng construction or the performance of <br /> c�-=truction.That I am authorized by the owner of this property to peRorm the work for which application is made znd I comply with the <br /> Contractors Law 18.27 RCW and 296.200 WAC. <br /> I Signature of OwnenContractor/Authonzed Agent Date <br />