Laserfiche WebLink
t <br />PLRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX A25-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PE IT # <br />o <br />LEGAL LOT NO. BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. % <br />a 6 Q S <br />OWNER ADDRESS CITY/ZIP PHONE <br />� re cs' t'` Eger &M IM 9 6ZoS;' <br />��.t.� (- <br />—W <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />E-MAIL <br />ONTR��CW�� <br />S �rn t ADDRESS CITYIZIP P ONE <br />CONTR. LICENSE # , 1 ` ^ `V �{Z%1 %�"(t <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />'Y-- Eleclric Gas Other <br />100 <br />O �-: <br />_ _ <br />1UV J <br />WORK DESCRIPTION <br />Pv'-No fprz; u�rnn c-rz�,� I�iZZ S5• ��. ��t a��=n,2 <br />tc : piste rD r <br />f=LUMBING <br />MIECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />'j <br />Toilet <br />_ <br />A/C — air handling units <br />Bathtub <br />I <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />T <br />Shower <br />Kitchen sink & disposal <br />Water healer <br />Gas fireplace <br />_ <br />Dishwasher <br />Clothes washer <br />Gas range / <br />Clothes dryer <br />Water heater <br />Range hood ' f <br />_ <br />= <br />Sink (servicelbar/mop/etc.) <br />Exhaust fan I h <br />BackOow preventer <br />Heat pump 6 <br />_ <br />Urinal <br />Unit healer <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />_ <br />Woodslove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 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 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 properly to perform the work for which application is made and I comply with the <br />State Contractors Law 118.27 RCW and <br />'2►96,2`00�WAAC. <br />Signature of weer/Contrac for/Authorized Agent �� Dale t <br />IZ <br />