Laserfiche WebLink
�.. �,_ <br /> PERMIT APPLlCATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-BB57-www.everettwa.org <br /> APPLIC.4TIONS ARE ACCEPTED FROM S AM TO 4 PM x �0� "O/b <br /> SITE ADDRESS PARCEL TAX I.D.A� PERMIT N <br /> %�33'� �t� � sr ��- �is33 � i � 6-�°�-�-�� <br /> LEGAL LOT1�NO. BLOCK TRACT <br /> DESC. 5'�\� 7� /(� � <br /> OWNER I ADDRESS CITY2IP PHONE <br /> ��ra I.JeS�h,n f0333 I t-YI� .��e. $r �✓<�-µ ��/( �11JJ� 1 <br /> TENA AME C/ONTACTFORPERMIT PHONE <br /> �nr �EstUh I V�r.. �Y.� � l� �s� d7v` <br /> 1 I' � C�TYITIP PHONE <br /> CONTRA R Cl /I l„JU�K- �'"1J �2DD n�C. �`' nun-'r <br /> J <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � J V� _Eledric �Gas_Other <br /> WORKDESCRIPTION �! �.�L �y-�"�rt�vv�n pI�„.i � ;•� �j Llni..n.Q.`y Pc,O�^'1. I ��D+ <br /> �,,,.:-1z� -Iz.,�)� � �1 J <br /> PLUMBING MECHANICAL <br /> N0. NPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITFM <br /> Toilet ,_ AIC-airhandlingunits <br /> Bathlub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Walerhealer <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes vrasher _ Clolhes dryer <br /> Laundry tray _ Range hood <br /> Sink(sen�ice/barlmop/etc.) _ Exhaust tan <br /> Z Backflow praventer _ Heat pump <br /> � Urinal _ Unil heater <br /> /) Drinking Fountain _ Boiler <br /> � Floor drain _ Refrigeration <br /> Grease trap T, Woodslove <br /> � Roofdrains � Olher "� ��� <br /> Olher — � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritiry that I have read and examined this applicalion and know the same to be true and correct. All provisions of laws and <br /> ordinaces govemino this type ot wark will be complied wilh whether specified herein or not.The granting of a pertnit does not presume <br /> to give authority lr,violate or cancel the provision of any olher state or local law regulaling conslruction or the perfortnance of <br /> construction.That I am aulhorized by the owner ot this property to perfortn the woAe tor wfiich applicalion is made and I comply with the <br /> State CoMractors Law 1�27 RCW and 296.200 WAC. <br /> �� ��� S/3 I /c7 G <br /> l.._ oe�e <br /> Signatutu�e��vnedConlractorlAuthonzed Agenl <br /> _J <br />