Laserfiche WebLink
�rEkMIT APPLICAT�vIv <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evei attwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.p PE MIT it <br /> �g�Y �in�r� �rre Olo -D/ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> pyyN A�D SS CITY2IP PHONE <br /> ����e�'/.Yr��.sr���.rs � �3ox sY�9 ��� <br /> TENANTNAME � CONTA FORPERMIT PHONE <br /> ��ECG�YI��U��c �i7�����Se� �ZS=3�Q- ?7g'?7 <br /> CON�T /CTOR AD�ESS �/• �1� �ITYIZIP PHO E <br /> c� 'u��t'irSo�Y m�/i1►/lC ��a' .c�� �—/�-?7 <br /> CONTR.UCENSE� �/'^�/T�(��'L q!1��J�1 <br /> �-,���� � rs c.� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �/�� �� _Eleclric _Gas_Olher Z�� <br /> WpqQ��RIPTION���� <br /> fL✓YI ��C�, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A!C-air handling unils <br /> 6athWb Forced air systems <br /> Z Lavalory(wash basin) _ Gas piping <br /> Shower W ater heater <br /> � Kitchen sink&disposal _ Gas lireplace <br /> Dishwasher Gasiange <br /> Clolhes washer Clothes dryer <br /> � Waler healer _ Range hood <br /> Sink(serviceNadmopletc.) _ Exhaust fan <br /> Backllow prevenler _ Heat pump <br /> Urinal Unil hea�er <br /> Drinking Founlain Boiler <br /> Floor drain R�frigeralion <br /> Grease trap Woodslove <br /> Rool drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TN(CODE IS 3105 <br /> I hereby ceriti(y thal I have read and examined this.:;p!�calion and know lhe same to be true and corcecL All provisions of laws and <br /> ordinaces goveming Ihis lype o(work will be complied wilh whelher specified herein or nol The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any otner state �r local law regulating consiruction or Ihe performance of <br /> conslruction. That I am aulhurized by the owncr of this proptrty to pedorm the work for which application is made and I comply with Ihe <br /> Slale Co ractors Law 18. RCW and 296200 WAC. <br /> � Z <br /> ' I.dA'GC ,�i —Z —Q� <br /> ig aWre o edConUacbdAuthorized Agent Dale <br />