Laserfiche WebLink
{ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <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 �� �5 _ U'j,} <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT S <br /> S ;o123`'`� J�i� l,J. �A �Sovo2ao2cb�� 7�= - �� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION M <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> �,r.. ,,J Corpor�-c �f � yy32 .VE �I �'-�' Sf Sc..,{f�e h �/!5 <br /> TENANTNAME CONTACTPORPERMIT PHONE ap`_�3_J�[(�f prf 2 <br /> / p ai'Q !3i-D D 1GS <br /> �,(�i�b���y�Ion. /�WtD� UJ�y.A� ° E.h1All ln.�"6CJPJ/¢l5 ee..�✓�c.co <br /> Zr6�FT�T�: �✓P/'4/'GP� Kc��¢r�o.�. �.2� S. �C¢,��._ 51' Jc.z+�G �Jg/D$ 2or.-�3-�'�I`/ <br /> V <br /> CONTR.LICENSE M E VF 2G�2�95�f R 2 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Electric +�Gas_Other $ ��jQ(� <br /> f <br /> WORK DESCRIPTION <br /> 1 s�ll ,,.� 1^ � !�� h � y ti�F�; cQK��h �c wwc� r� <br /> n o GaS 'ri+'n4ce� vnc 2.� S , q�L �.l U-n�l- Wo� u. <br /> ✓ <br /> GQe�ic�3 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) � Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal 3as fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) � Exhaust(an <br /> Back(low preventer Heat pump <br /> Urinal I Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roo(drains _L Olher .S ...� �•- <br /> Olher _ <br /> — — —� <br /> CITY OF EVERETT LOCAL SALES TAX CUDE IS 31Q5 <br /> I hereby certify thiat 1 have read and ezamined this application and know the sart�e to be true and correct. All provisions of laws and <br /> ordinances gove•ning this type o(work will be complied with whether specified herein or not.The granting of a pertnit does not presume <br /> lo give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction.Thal I am authorized by lhe owner of this property to perfor,m lhe work for which applicalion is made and I comply wilh the <br /> Stale Contrac� rs Law 18.27 RCW and 296.200 WAC. <br /> {'�,,/:e�'�-'�^o,y� S���U <br /> Si ature of OwnedContractodAuthorized Agent Date <br />