Laserfiche WebLink
F��RMIT APPLICAT��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 PROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITEAC7RESSi/Cj/[�. /9f�/j �/E �lSti pARCELTAXI.D.# PERMIT# <br /> S , O � 0 OOLLOO 00 D�4(�} �_ <br /> LEGA LOTNO. BLOCK TRACT � ��U7 ��J\ <br /> DESC. J <br /> OWNER qDDRESS CITYIZIP � PHONE �tj.��2q�_ 65- <br /> K�m, 7���,;� -�un� si�� -���h pir� I�,RU, SE. clv3 Zs�y�.�l,. ws�(�$�-O I <br /> TENANTNAME CONTACTfORPERMIT PHONE <br /> �-r�r �ya� i I�'IUy � 11L <br /> CONTRACTOR ������/5 N�vN S�E(rvs ADDRESS CITY/ZIP PHONE <br /> a� I(, l0.�TVi ��' S� buEk'_�T-f C4�y�75v`��a4 <br /> CONTR.LICENSE# MIK�SAJ S(��j�jC �L W� c�$�o� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric Gas Other "� E7�u � <br /> WORK DESCRIPTION <br /> I tJ 57 n��.�s lJ � 1= �- g/� c.K i�T 5 I 4 rJ S . <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—afr handling units <br /> Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> Laundry tray ' Range hood <br /> Sink(servicelbar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinai Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> _ Other ti�C'J SILaNS _ <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 � <br /> i hereby ceritify that I have read and examined lhis applicatlon and know the same lo be lrue and correct. AII 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 nol presume <br /> to give authoriry to violate or cancel the provision of any other state or local law regulating constructien or the pertortnance of <br /> construction.Thal I am authorized by the owner of this property to perform the work for which applicalon�;made and I comply with the <br /> State C tors Law 18.27 RCW and 296.200 WAC. <br /> ������Y�f�'�- .— /� " �� <br /> Signature of Owner/Gdntrec or Authonzed Agent Date � <br /> Z <br /> J <br />