Laserfiche WebLink
PtRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />125-257-8810 — FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS J l <br />� )l1 lV <br />PARCEL TAX I.D. # <br />PERMIT # <br />�OEee� 02- <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION k <br />DESC. 4; - <br />. -t0 7 <br />OWNER ADDRESS CITY/ZIP PHONEpq� <br />Jatoes A. 0 cpra 'Zr/ati, c274 e i. L r ft1%.A. 4l25-35-37779 <br />TENANT NAME CONTACT FOR PERMIT PHONE "/,.�5 3(_i $ 520 1 <br />A � q E-MAILJl �r�rV GU Chid (+�AeL <br />�v� , • •' �rn / 1.c n�m s� n i�r <br />i;ONTRACTOR ADDRESS CI IZIP <br />CONTR. LICENSE b / <br />nna6 0L9 q, oJL <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br />6i,)' rrl ?�— i I C���/C L — Electric _K Gas —Other I G/133��2 <br />WCFfK DESCRIPTI/ON I' <br />I VI � L� �ICJU <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet % I ` <br />_L_ <br />A/C — air handling units <br />" <br />Bathtub I ` ;_...:_ ..._:_ .. _ -._.. <br />J— <br />Forced air systems <br />Lavatory (wash basin) 11 t ( <br />Gas piping <br />2 <br />Shower I I <br />Water heater <br />4— <br />Kitchen sink & disposal ` <br />q <br />Gas fireplace <br />Dishwasher \ <br />I <br />Gas range <br />1_ <br />Clothes washer I <br />; _L— <br />Clothes dryer <br />I <br />Water heater I <br />Range hood <br />1_ <br />Sink (service/bar/mop/etc.) 1 <br />3 <br />Exhaust fan <br />I <br />Backflow preventer ..... _ <br />Heal pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing 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 to violate or cancel the provision of any other stale 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 />S Contractors Law 18.27 R and 296.200 WAC. - 3 <br />1 <br />Si ( nal o vmer/Contractor/Autho led Agen Date <br />S( <br />ceM I <br />