Laserfiche WebLink
PtRMIT APPLICATIVN <br /> CITY OF E�✓ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPUCATIONS ARF :;.;�EPTED FROM &AM TO 4 PM ��,��a ...-D � <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# , <br /> � � ; /� S �'� ao/o /�o o . .Q 7 Z ' �l <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# � <br /> DESC. ' <br /> �OWNER � ADDRESS � �/ CITY/ZIP PHONEl�Zf--C�� `3OS <br /> ����� o � " ���o7��Yl��l� ����� ���'/��✓� G,/ E(�'u:�`�4�zo y. <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I/ <br /> E•MAIL <br /> CONTRACT R � ADDRESS ITYIZIP PHONE <br /> CONTR.LICENSE# � \ <br /> USE OF BUILDING p�'���y HEAT SOURCE 1CONTRACT PRICE OF WORK <br /> �.�,�_��'�` -7 �' _Eleclric _Gas_Olher �I /1 QC QQ� <br /> V// <br /> WORK DESCRIPTION w,N�_�� i y ���` <br /> .! l�1SfALL j Ii/ c--c� <br /> �:.�,sz,u� oc�up�r���(� � 70 ,�,,�,� <br /> PLUM6ING MECHANICAL <br /> NO. TYPE OF FIXTURE CR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> � Bathtub Fnrced air systems <br /> Lavalory(wasli basin) Gas piping <br /> Shower Waler healer <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Waler healer Range hood <br /> Sink(service/bar/mop/etc.l Exhausl fan <br /> Back(low prevenler Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> � Floor drain Refrigeralion <br /> Grease trap Woodstove <br /> Roo(drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3'105 <br /> I hereby cerilify that I hava read and examined lhis applicalion and know the same lo be Vue and correcL All provisiens of laws and <br /> ordinaces governing this type of work will be com?lied wilh whether specified herein or not.The sranling of a permil does nol presume <br /> lo give authority to�iolate or cancel lhe provision o(any olher state or local law regulaling construction or the performance of <br /> construclion.That I am authorized by lhc owner of lhis property to perform Ihe work for which applicalion is made and I comply wilh the <br /> Stale Cuntr tors Law 18.27�2CW and 29�.200 WAC. <br /> , /�i1. ^ <br /> Signature o(OwnedCun actodAulhorized Agent Date <br /> I ��z <br />