Laserfiche WebLink
� ( _ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C�DAR 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 �..((�.-(� <br /> SITE ADDRESS C'��L��J/� PARCEL TAX I.D.# PERMIT# ` <br /> 9 D .2��' �',� 5, �iS:�oB 7�8 5�3- '3-c5c�d l � �tc - <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Lar �fz -P� ��`101 ���-'Qrt✓e SC E✓tre�" %ff.208 <br /> TENANT NAME � CONTACT FOR PERMIT PHONE (,'�)—y��—7y 7� <br /> ����n,M_� a� n,J.-.�r I � �wY-"c�9 E-MAIL Gr�st��:-.i���CJA, .M <br /> y �irvrz�—�raw�— <br /> G�J- C_ans�4��1i�^ , 1^c. pD Bo,t 13Co91 M;(( Cree1C `t&�3� /-�eZ5 -Y7�I-7y c.� <br /> CONTR.LICENSE# �� ; - <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �/D X Electric _Gas_Other a ��OUG <br /> / h <br /> � <br /> WORK DESCRIPTION � , <br /> Ar�J .Zr� ���a�J� 1�..� 1D':-���c)« X ^�I -G ��N� <br /> Ac,j1�J C:r.,El� 2n�.�.. a�l- l�ac,raf �(x� �s}i..� + �z,..1,�ro�z .la���xP � �o `�..i�Je <br /> ' � 1N � �uC-�\(AlJ C. ,1 �� t�..�G� �MGTL-N ��1�J1�\. U�^l'V{1 .�tATt'fla � <br /> PLUMBING MEC NICAL • <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet _ NC—airhandlingunits � <br /> Bathlub � _ Forced air systems <br /> Lavalory(wash basin) _ Gas piping � , <br /> Shower _ Water he3ler <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwashe� _ Gas range <br /> Clothes washer _ Clolhes dryer <br /> Water heater _ Range hood <br /> Sink(servicelhar/mop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump . <br /> Urinal _ Uni�heater . <br /> _ Drinking Four�tain . _ Boiler • <br /> Floor drain _ Retrigeration — <br /> Grease trap _ Woodsrove � <br /> Roof drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES 7A%CODE IS 3105 <br /> I hereby certify that 1 have read and examined lhis application and Know the same to be lrue and correct. All provisions of laws and <br /> ordinances govarning this type of work will be complied with whether speafied herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or loral law regulating construction or the peAormance of <br /> construction. That I am authorized by the owner of this property to per(orm the work for which application is made and I comply with lhe <br /> State Contractors law 8.27 RCW a d 2 6.200 WAC. <br /> ��- �� /�g , ��o�o � <br /> ;ic�nat�y y Owne/ ntractodAuthonzed Agent Date /� <br /> % <br /> � ' <br />