Laserfiche WebLink
� cRMIT APPLICATIG�I <br /> CITY OF EVERETT PERMIT SERVICES — �� —°S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � � <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.or �/ �� �� <br /> %� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT�CREDIT CARDS�bT AC_ <br /> SITE ADDRESS PARCEL TAX I.D.# ERMIT# <br /> i� a ��a�0 � ��4ros �O57y o0�0�6o Bosa6 -vsv — <br /> LEGA LOT NO. BLOCIC TRACT <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> .p„uGY�Q,r, V��o�w-� �U. Bo,c los9 �nofwwisl., 98Z41 y�s 3s�f so1S <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACTOR �u�sV�II� lt �up���- ADDRESS . CITY2IP PHONE <br /> CONTR.LICENSE# �p� VS��'�I�� �33�� s� �3°NC 1M1�����'�' �23 3�� y35 Ssts I <br /> �I 1 I <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR�TEM <br /> _� Toilel _ PJC—air handling units <br /> Bathtub Forced air systems <br /> _L Lavatory(wash basin) Gas piping <br /> Shower � Waler heater <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clolhes dryer <br /> Laundry lray Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> BackOow preven[er _ Heatpump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br />� _ Floor dr2in _ Refrigeration <br />� Grease trap _ Woodstove <br /> Roof drains, _ Other <br /> 7— Other Sln.,�' <br /> CITY Of EVERETT LOCAL SALES SAIC CODE IS 3105 <br /> I hereby ceritify that I have read and examineA this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or nol.The granting of a permit does not presume <br /> to give authority lo violate or cancel the provision of any other state or local law regulating construction or lhe performance of <br /> construction.That I am authorized by the owner of this propeRy to per(orm ihe work for which application is made and I comply with the <br /> Stat�r�t�ctors Law 1 7 RCW and 296.200 WAC. <br /> f/�v� 7/(J��S <br /> SignaWre of OwnedContractor/Authonzed Agent � Dale <br />