Laserfiche WebLink
P�tRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE7T, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM s�/ ` �_ �� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> p O �� /+� �1 ,6. ��� � ada.q <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> _s,ro�-na� e.�c.�sno r�» <br /> �� sra� .5an+�e� z7a7 �OLgY #/2i0 E�,�.-� ��1e� �SZ-sgav <br /> TENANT NAME CONTACT FOR PERMIT PHONE 25 �/L� <br /> A, �aev o��«�, ,��� �4 �i�, J <br /> E-MAIL nd✓y0 �/LU� <br /> ONTRACTOR� ADDRESS �n'� �P —r <br /> % <br /> CONTR.LICENSE il ��� ,- . <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> I _Eleciric _Gas_Olher <br /> WORK DESCRIPTION <br /> Q.w'�UG✓AT[cN �sA/JlJ�Ptcl.+ 7d �1Cl51'/NG /� �/LD/ivG. <br /> � ���� <br /> PLUMBING MECHANICAL ' <br /> NO. TYPE OF FIXTURE OR ITEPA N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Balhtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Waler healer Range hood <br /> Sink(service/bar/mop/elc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> _ Drinking Founlain _ Roiler <br /> Floor drain Refrigeretion <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriti(y that I have read and examined this application and know lhe same to be true and correct. All provisions of laws and <br /> ordinaces governinp tliis lype of worf,will be complied wilh whelher specified herein cr not.The granling of a permil dces nol presume <br /> to give aulhoriry to v�olate or cancel the provision of any other state or local law regulating construction or the periormance of <br /> construction a am aulhorized by the owner o(this property lo perform lhe work(or which applicalion is made and I comply with lhe <br /> State Co 1 aw 18.27 R nd 296.200 WAC. <br /> �" 7 d <br /> ig re ed a od horized Agent Date <br /> f '/� <br />