Laserfiche WebLink
;�,. <br /> _, - . <br /> s r. . <br />,, .� �- <br /> r <br />� '��� ��� F �RIVIIT APpLICA�'IuN <br />�, t;'.�'.'=_._.: <br /> CITY OF EVERETT PERMIT SERVlCES <br />�I� �� ' 3200 CEDAR STREET, EVERETT, WA 98201 <br /> '� "' I 425-257-8810 - FAX 425-257-8857-www.everettwa.org /���'�_ /;/� 7/,,, <br />�.,;V;�:. ��,f0 � iu <br /> � <br /> _ APPLICATIQNS ARE P.CCEPTED FROM 8 AM TO 4 PM - DEBIT& CRECIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# � <br /> 3 3 � 5 T, e��-�,�, <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. - <br /> OWNER ADDRESS CITYIZIP PHONE��S��S� � , <br /> �• ��it►�J �%✓�en. ]�1�5 ��.23 � 7 �" ST. �t.�¢r� 3ZJ3 <br /> TENANT NAME I CQNTACT FOR PERMIT PHONE <br /> 5�/Q-/v��' <br /> CONTRACTOR �CyC��`�y�N ADDRESS /`��K� CITY2IP pHONE 3(�D�yay� <br /> � �� ff7 � �1or.wr !%aua� �47,� <br /> CONTR.LICENSE# A.F`p�CR�� �//�S <br /> /�[ <br /> +-: USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF'NORK <br />'� I � Electric x Gas_Other I"��pa <br /> K I <br /> z``4'" ' WORK DESCRIP71pN <br /> l�6iv7�iN�( �I,e f� /VEs-✓ G.�it.�i✓� �.C/�A,✓�T �ioN ..�i✓ <br /> �7'—ia�iC" Cii¢Cs�K ai�o�r,.4�✓0! vE... n:s��J �2 .4�I!6fBc. C/o f�,` S <br /> ��E�e `' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM I <br /> _ Toilet A/C-airha:idlingunils <br /> _ Bathtub Forced air syslems <br /> _ Lavalory(wash basin) Gas piping <br /> Shower Waler heater <br /> _ Kitchen sink&disposal Gas fireplace <br /> _ Dishw;,sher Gas range ri <br /> _ Clothes washer �� Clopies d er_ " <br /> a ,�le e,Se;a v c.�,-:,v9 a� <br /> _ Laundry tray Range hood �� / <br /> _ Sink (service/bar/mop/etc.) _� Exhaust fan — �/�. � /i�,�T On/f. �� <br /> _ Backflow preventer _ Heat pump <br /> Urinal Unit healer <br />`r �� Drinking Fountain Boiler <br />'��_, Floordrain — <br />�,, = Refrigeration <br /> �7I Grease trap Woodstove <br />�, � � _ RooF drains Olher <br />; Other — <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby ceritif�that I have read and exar�ined this applicalion and know the same to be irue and correct. All provisions of laws and <br /> ordinaces govarring this type of work will be complied with whether specified herein or not The granting of a permit does not presume <br /> to give authority tn vic;ate er cancel the provision of any olher state or local law rec�ulating construction or the pe�ormance of <br /> construction. at I a authorized by the owner of this property to perform the work(or which application is made and I comply with the <br /> Slate ConU c a 18.27 :W and 296.200 WAC. <br /> �p�r o S <br /> Signalure of OwnedContractor/Aulhurized Agent � Date <br />