Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <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 I <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT N <br /> V.� re ��e q 6 2 002 ^ Lvo - .�� <br /> LEGAL LOTNO. BLOCK TRACT <br /> oEsc. Z 6� <br /> OWNER pDDRESS CITYTP PHONE <br /> '�JO��w �Cv�v��....'n T'o� � l��Z W /��wn�fY �.lo C�I�Yt+� �f{ ��{'Z 'r 7 <br /> TENANtNAME � I CONTACTFORPERMIT � PHONE � �� <br /> �S�.�w. �1.�. v.�:.�-�{h�^ ll (zob���o 0136 <br /> CONTRACTOR a�,�e,r- ADDRESS CI P PNONE <br /> CONTR.LICENSE N <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _ �.jC�aG S�� _Elednc _Gas_Other I -�j3CJo <br /> c3 <br /> WORK DESCRIPTION ` �/ <br /> R��0.\'� Y X1`�lT\� �V�� 22� T <br /> ,NC�Glv ���� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toi�et A/C-air handling units <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kdchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> Sink(service/badmoplelc) Exhaust fan <br /> BackAow preventer Heat pump <br /> Unnal Unit heater <br /> Dnnking Fountain Boiler <br /> _ Floor drain Refngeralion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAJ(CODE IS�105 <br /> I hereby centify that 1 have read and ezammed this application and know the same to be hue and correcl All provisions of laws and <br /> ordmaces ming lhis type o(work will be complled wit whether speafied herein or nol 7he granting of a permit dces not presume <br /> Io give a iry to v olate or the provision of any ther state or local law regulating construction or the performance of <br /> I consiruct . Thal am aulh z d b he owner of thi ropeAy tc perform the work for which application is made and I comply with the <br /> I State Co actor aw 1 an 2,96200 W . <br /> i <br /> � � �_. � <br /> � Signalur o O ieNContractor/ uthonze Da �' <br /> (� �0�:� 1�Z <br /> � .- --- ----- -------�--�- � ----- /_ <br />