Laserfiche WebLink
PEI2MIT APPLICATION <br />° GITY OF EVERETT PERRVIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM b AM TC 4 PM 3 _�'��,p� <br /> SITE ADDRESS PARCEL TAX I.D.# ERMIT# <br /> li �► i `I �I`�h Av-� st � io� o s�� �oolol c� l 7�� - d33 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> y 1s- <br /> � U 1 ctrr.�i/1 �e.cJk.� �fl� l�0 (�X 10�� Srvhorn�th I,uA �`11 33�! Tat$ <br /> TENA NAME CONTACTFORPERMIT PHONE <br /> C L �eve�lo 1`�x�c�r� Gr��'v Cupi�<<I (�rc���ec4� �S HI V�� y�s 3t7 - 80�� <br /> CONTRACTOR � ADDRESS CITY2IP PHONE <br /> P �u�-� �.v�5� cor� � P.o.R�o�c nY1,��3-a�� uas ��� <br /> CONTR. ICENSE# � L�/,-E 1 W CI ��K(J 3s3� � " °�3 ���� <br /> V <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �fc��1r�� S.�C fP _Electric _Gas�Other I� ' �.�`> __ <br /> WORK DESCRIPTION <br /> -�� r« n-4- Z,,�pra Ve.,��� <br /> PLUMDING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM O. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathtub F�rced air systems <br /> Lavalory(wash basin) _ vas piping <br /> Shower aler heater <br /> Kitchen sink&disposal G fireplace <br /> ishwasher Ga ange <br /> lhes washer Cloth s dryer <br /> Wa r heater _ Range od <br /> �' Sink( rvice/bar/mop/elc.) _ Exhaust <br /> Backflow eventer Heal pump <br /> Urinal Unil healer <br /> Drinking Founta' _ Boiler <br /> Floor drain Refrigeration <br /> = Grease lrap \ _ Woodstove <br /> Roof drains Other <br /> Other — <br /> � � <br /> CIIY OF EYERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify lhat I have read and examined this application and know the same to be true and correcl. All provisions of laws and <br /> ordinaces goveming lhis lype o(work will be complied with whelher specitied herein or not.The granling of a pertnit does not presume <br /> lo give authority to violate or c3ncel lhe provision oi any other state or local law regulalinc�construclion or the performance of <br /> construclion.T t am aulhorized by lhe owner of lhis property to per(orm the work for which application is made and I comply with the <br /> Slat c r 18.27 RCW and 296.200 WAC. <br /> ' 27i°�1 <br /> Signa w � lrectodAuthorized A,yant Date <br />