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-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> SITE ADDRESS PARCEL TAX I.D.N PEf�M1T N � <br /> i12z� si��Y-.n �mtF- n�n� <br /> LEGAL LOTNO. BIOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CITY/ZIP PHONE <br /> c�r i �t- C-�L.n-/z� 3zoo c,,o,.,�. S�. Fv2Ph7m wf . <br /> TENANTNAME CONTACTFORPERMIT PMONE <br /> Fv�� �hT Y (L� S7vtT1 �1"1� 7 <br /> GONTRACTOR ADDRESS CITYIZIP PHONE <br /> US(/�+J( (�iZ(z �S'1+��Y�P^N C�, S)ay i,.�. i3cL��k�F`1 �Lr', kr-..r.�wA. 95318 5�`+� 78:7-',�17� <br /> CONTR.LICENSE N <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> [leclric Gas Olher �SS 1f� }- ��/J ST I/J(J,79 <br /> WORK DESCRIPTION ys;Y rn <br /> IIfSlJ�tl Nr-vl� i I �L�L S��i V�CL�IL � 1 �TYO��. <br /> , �/� ¢ �gi�s.79 <br /> C � /,'LCXCG��—, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXNRE OR ITEM <br /> Toilet A/C-air handling units <br /> Balhlub _ Forted air syslems <br /> Lavatory(wash basin) _, Gas piping <br /> Shower __ Waler heater <br /> Kilchen sink 8 di:posal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer _ Clothes dryer <br /> Laundry Iray _ Range hood <br /> Sink(servicelbadmop/etc.) _ Ezhausl fan <br /> Backllow preoenler _ Heat pwnp <br /> Unnal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refngeralion <br /> Grease irap _ Woodstove <br /> I _ Rool drains � Other I`�RR. Pti�'Y=��, ��� <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�705 <br /> I hereby ceritify Ihal I have read and ezamined this appliwtion and know the same to be We and coved. All provisions of laws and <br /> �� ordinaces governing ihis type of work will be complied with whelher specified herein or nol The granting of a permil does nol presume <br /> to give authority to violate or wncel the provision ol any other state or local law regulaling conslruction or ihe pedormance of <br /> construclion.Thal I an�authorized by Ihe owqerof this property lo peAorm the work for which applicalion is made and I comply with Ihe <br /> State CoNractors Law-183 �RC ��a 2ss:z9o-�vnc. <br /> , <br /> ,,�� �� � ,:��� ��z �io� i� <br /> Signeture f wiedConlracloi,Ifutho�Agent Dafe <br /> � <br />