Laserfiche WebLink
� <br /> -RMIT APPLICATI(..N �� <br /> CITY OF EVERETT PERMIT SERVICES <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 I l ` I S—�� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# � <br /> /�C�,�2S' /`rr�' !{�le S� ��//' GdS <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> ��GC�5��.� 2$ /�CJ'.�S- /�! "� !I*�� S c.r �7/ek_�-�/Cc/!=� id��'o� <br /> TENYtNT NAME CONTACT FOR PERMIT PHONE <br /> Sv��K� I <br /> CONTRACTOR ��DIIlJN'1 p AODRESS CITY2iP PHONE <br /> /LG��nO/i�17 Z .�.JD �+ <br /> CONTR.LICENSE# eOISI/1%'v� Z7ZG' Z- ��"�C��<1'Trm W/¢ (�' ZZ� 3G6 �/!%J�-��/� L I <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Elecfric _Gas_Other 7 d� i <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> / Toilet A/C–air handling units <br /> B�lhlub Forced air syslems <br /> T Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> � Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> _(_ Waler heater _ Range hood <br /> Sink(service/badmop/elc.) Exhausl fan <br /> Backflow prevenler _ Heat pump <br /> Urinal Unil healer <br /> Drinkinc� Fountain _ Boiler <br /> Floor drain Refric�eration <br /> Grease frap _ Woodslove <br /> Roof drains Other <br /> � Olher /�ii7 �ixcJ'- – — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify lhal I have read and examined this application and know the same to be true and correcl All provisions of laws and <br /> ordinaces goveming this fype o(work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give aulhority to violate or cancel lhe provision of any olher stale or local law regulaling construclion or the performance ot <br /> construclion.That I am authorized by the owner o(this property to pertorm lhe�vork for which applicalion is made and I comply with the <br /> Stale Contractors Law 1827 W and 296.200 WAC. <br /> ��ll.._O,� _ �t �/- �s'zavc <br /> g ature of OwnedConlraclor/Aulhorized Agent Date <br />