Laserfiche WebLink
( <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER"ICES <br /> 3200 CEDAR STREET, EVERETT, WA 9 I <br /> ( 425-257-8810- FAX 425-257-8857-www.ev� .wa.org n ,1���% �in� <br /> //1� /L� <br /> I �js APPLICATIONS kRE ACCEPTED FROM 8 AM f0 4 PM �`-�� <br /> SITE ADDRES�, � �� ��.�-') �}'� � ' P R L TAX I.D.# � PE IT# /� <br /> � ' � "��5 UU�DU F � , <br /> �rL I I (� �V6i{LL rf /k � � � L > C, �OU J uV�J <br /> LEGAL LOTNO. � BLOCK TRACT `/. '� l {-� ./` <br /> DESC. 'I �k' ��I I VY/�A K-C„ l�1�C�,t� TYGI L LJ <br /> OWNER �' 1 �� 11�V����„t.���r- ADORESS � � CIN21P PHONE <br /> J 1✓ ca�1 ZS � �i �. aJE n;� 4�z� -Slz- 44:�� <br /> �i�Zu.,h�l�� q�y�� <br /> TENANT NAME C TACT FO ERMIT <br /> ✓� +" PHO <br /> pr. Cvlle�n 1"�'�ct�•.� n, ei �`- � ���c�� -,� 4 Ly - <br /> i�1�1��i�IJJ � (y70�ir>> �L <br /> CONTRACTOR ��f ��1�I �ILI C�V ADDRESS CITYIZIF PHONE � z�— <br /> ����� ��25 ? 4 bs— <br /> CONTR.LICENSE• � <br /> Tv I'.�'_ I�+`L�✓�dE1a— ��pun � Ssucc,� C,Cr l �UD <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���� C-�"L�� UFF�Lr`j __.Eledric �Gas_Other I '�� ���i J�:> . U� <br /> WORK DESCRIPTION <br /> i N� r� � ?� �� h��� �u� ���,v� , ,Na�.,�z. <br /> �1��.J N��,=h�rm u���r� 5, �..z�-�.,.�<< � , no��s <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling uNts <br /> Balhtub Forczd air systems <br /> Lavatory(w3sh basin) Gas piping <br /> I _ Shower Water heater <br /> � Kitchen,irk&dispo;al Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washei Clothes dryer <br /> laundry tray Range hood <br /> Sink(serv;ce/hadmop/e.c.) Exhaust fan <br /> BackFlow creventer Heat pump <br /> Urinal Unit heater <br /> _ DrinKing Fountain Boiler <br /> _ Floor drain Refrigeration <br /> Grase lrap Woodstove <br /> I Roo�drains Other <br /> Ol;:er <br /> CITY OF EVERETT LOCAL SALES TAX CO�C IS 3105 <br /> I hereby cen6(y that I have read anc?examined this application and know the same to be We and corred. All provisions of laws and <br /> ordinaces goveming this type of�vork will be complied with whether specified herein or noL The granting of a pertnit does not presume <br /> to give authoriry to violate or cancel the provision of any other state or local law regulating construction or the periortnance of <br />� constructioa Thal I am autkorized by the owner of i�.is property to perfortn the work for which application is made and I comply with the <br /> State Coniradors Law 1827 RCW and 296.200 WAC. <br /> ��L�.% G(r�i-h.�J�1-�f�./�7iI� l l- lD-�S <br /> Signature of OvrnedConiract ip 7 u�honze� Date <br /> �_ <br />