Laserfiche WebLink
I <br /> P�RMIT AP!'LICA7'IC�N <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br />;-. � ,_ 425-257-8810— FAX 425-257-8857— www.evarettwa.org ���,�� _� --� <br /> i,;:.'��� J <br />;r:,!4�&���= <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />��tl y�s •'i' <br />�„ SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> t�z,�' `f� /� STs� v�� rY��� � e ,soa <br /> � �� - � <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. � L/I-� ��/t'- V <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> �2f-�7 S-rzzy <br /> ;'� �'�J /�a�,-�� �- � ��C /� G.�vn io CL/iY>ati �rt � �zJ� <br /> TENANT NAME c:ONTACT FOR PERMIT PHONE <br /> S�i_-c /( o�e� � �Rf%=�r 5'�r-z� � _- �azy <br /> CONTRACTOR ��lJ /�/}/,'�(- C/7E�hGCc ADORESS CITY2IP PHONE <br /> CONTR.LICENSE# <br /> /�itR�(- � L �O/ Z tT� �/G/.7o.ry/o C<iN7SN� G�JQ9fL�G �f2r- 2pF912� <br /> USE OF BUILDING � HEAT SOURCE CONTRACT PRICE OF WORK <br /> ,5,�,`� �,�,�/ ���,7 _Electric � Gas_Gther -�j fi�� v <br /> i <br /> WORK DES RIPTIO <br /> �f3�'7 �� �!3-YJwj <br /> Pt�A C-2 <br /> PLUMBING MFCHANICAL <br /> NO. TYPE OF fIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilet A/C-air handling units <br /> .2 BathWb �- Forcedairsystems <br /> .3� Lavatory (wash basin) 5� Gas piping <br /> n .� p , �_ Shower � Water heater <br />«+°-` ,? i / Kilchen sink& disposal / Gas fireplace <br />�:' � .i � Dishwasher / Gasrange <br /> � / Clothes washer / Clolhes dryer <br /> .--.��� _ Laundry tray Range hood <br /> Sink (service/bar/mop/etc.) �� Exhaust fan <br /> J ' � Backflow preventer _ Heat pump <br /> Unnal Unit heater I! <br /> Drinking Fountain Boiler ! <br />`�� , Floordrain Refrigeration � <br />! `' ^ Grease trap Woodstove I <br />' ��;�_�' Roof drains Other <br />} U.� � - I <br /> Pn ����;,< �:.� I — Olher _ <br /> I — — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' <br /> � I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> � ordinaces governing this type of work will be complied with�vhether specified herein or not The granting of a permit does not presume <br /> to give authonty to violate or cancel the prcvision of any other state or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and i comply with the <br /> � State Cqnt ctors w 1827 and 296.200 WAC. <br /> �� '�,�i(/ � G- .i7- � � <br /> Signature of OwnerlContractor/Authorized Agent Date <br /> r r .; � <br /> S ..y .. <br /> i�� ��i <br /> '.�' I <br /> G-' <br />