Laserfiche WebLink
� pERMIT APPLICATIUN <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 FROM 8 AM TO 4 PM � ..1(�-O� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT <br /> i2acu ,��'�' Qve . , �vc�-7-r 28053�o�72r�o ',�OJ -., 7 <br /> .L <br /> LEGAL LOT NO. BLOCK TRACT OR SU801VISION# <br /> DESC. <br /> OWNE ADDRESS CITYIZIP PHONE <br /> PR�/�b�(�Ir'� 6vFA""c?" (42572101•4� <br /> MGC-�(GA(- G�E�Ct"E� �'bZI C�L�Y AVE, 'EVE�'Ct'[-' �g2Qa <br /> TENANT NAMF. CONiACT FOR PERMIT PHONE(425 25�• 08Co� <br /> �`�� �ve��rr .p�vi�1 saY� ofz • <br /> ��«�- =-��� E-MAIL�YIY]C:'�71"1�'fSt"L"�. <br /> TRACTOR � A M�C��� ADDRESS - I ! IP P ONE <br /> 1,¢� I� NE 2�TM t�L .��y� C425�8�J5• � <br /> �ONTR.LICENSE tt�G7k�p��}y� <br /> �BG�� <br /> U�E OF BUILDING � � HEAT SOURCE CONTRACT PRICE OF WORK <br /> aIJYPA'CI�C(' GL(l�llG 8 <br /> _E�ectric X Gas^Other � 150� �e��. 00 <br /> WORKDESCRIPTION -��.,�A��-- l�(�.(GNIEI�I�C 'I�L�-/S��(�C(' O� �?C1�1�11�1G-� <br /> �'t�.xaL�Y �t.iUt��-,rt' oe-1 -rt-lF_' �(�'t' �Lc��-z . <br /> PLUMBING ' MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF fIXTURE OR ITEM <br /> Toilel. • A/C—air handling unils <br /> BalhWb Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower VJaler healer <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> Water heater Range hood <br /> _ Sink(serviceNar/mop/etcJ Exhausl fan <br /> Backflow prevenler Healpump <br /> Urinal Unit heaicr <br /> Drinkin� Founlain Boilar <br /> Floor drain Re(rigeration <br /> Grcase trap Woodstove <br /> Ro�f drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CnDE IS 3105 <br /> I hereby cerilify that I have read and exarcined this applicalion and know the sam�to be true and correcl. All provisions of Iaws and <br /> ordinaces c�overning lhis type of work will be complied with whether specified herein or nol.The yranting of a permil does not presume <br /> lo givc authorily to violate or cancel the provision uf any other state or local law reguldling construclion or the per(ormance o( <br /> construction. Thal I am aulhorized by lhe owner of lhis property to perform ihe work for which application is made and I comply wilh the <br /> Stale Contracl�rs Law 10.27 RCW ard 296.200 WAC. <br /> �-- <br /> ��,�nt�__ � I ' I�f- ' 08 <br /> Signature of OwnenContra�l uthor�ed Agent Date � <br /> 2 <br />