Laserfiche WebLink
PtRMIT APPLICATI(�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 /> APPLICA?IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# P RM�T# <br /> � �I 1 �1 L`1`�r ��.e. SE �OS O ( " � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. � <br /> OWNER ADDRESS CITY2IP PHONE j,��- <br /> Da ara�n �e,ue�n t��� P.O.CPS�K 105`i 5noho1��51� � I 33`1 -5�1� <br /> TENA TNAME CONTACTFORPERMIT PHONE i1r��' <br /> I , Sr-v��.ra ��cl 'L' Capi+n� nrc���'�'�'s 3!7 - 80�7 <br /> CONTRACTOR �����.GjQ'� ^ �Y . ADDRESS CITY2IP PHONE � O <br /> p P o� �u 3s3s Aflr��s-� ��aa3 �la� 9 <br /> CONTR.LICENSE# �UC�E-rwc �3`1KG �� J� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE O�WORK <br /> �jC'.� S�iC.�..s _Electric _Gas�Other �O���U <br /> WORK DESCRIPTION <br /> 'f'e�no �-F. Tm,��ov�en�,n�' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYI'E OF FIXTURE OR ITEM <br /> Toilel _ A/C-airhandlingunits <br /> Bathtub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Waterheater <br /> Kilchen sink&disposal _ Gas tireplacr: <br /> Dishwasher _ Gas range <br /> Clothes washer _ Clothes dryer <br /> Water heater _ Range hood <br /> Sink(service/badmop/elcJ _ Exhaustf2,n <br /> Bar,k(low prevenler _ Heat pump <br /> Urinal _ Unil heab�r <br /> Drinkinc� Fountain _ Boiler <br /> Floordrain _ Refriger3lion <br /> Grease lrap _ WoodsWve <br /> Roof drains _ Other_ <br /> Other — — <br /> CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br /> I hereby cerili(y lhal I have read and examined this applicalion and know lhe same to be�true and correct. All provisions of laws and <br /> ordinaces governing lhis lype o(work will be complied wilh whether speci(ied herein or not.The Qrenting of a permit does not presume <br /> lo give aulhority to viol le or cancel the provision of any other;tate or Iocal law regulating consiruction or the performance of <br /> conslrucf - I fn au orized by the owner of this property to perform lhe work for which application is made and I comply with the <br /> Slale C ntr c i � RC and 296.200 WAC. <br /> , 7,7`-'Grc <br /> Signature o ed nlractodAuthorized Agenl ate <br /> � <br /> i <br />