Laserfiche WebLink
I � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, W.A 98201 <br /> i 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> �� i ��n <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CRtDIT CARDS ARE NOT ACCEP"ED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> I z?��� � 13�n-�i�.�C-_v�„- ���H� I - ��'- ?.3 � ?. a6 002 <br /> LEGAL LOTNO. BLOCK 7RACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> ��:��YlT7l'J\IC1� �'IU-Sf�iTA t <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> �Jol+;-l.� C�u�h'Y ��.t�rnBi�iC���UG ��0.13oxCr��-7 L.ANv�ti05� (uh . yZ.�-`1-1�-1�7-] <br /> CONTR.LICENSE# <br /> �� �1r3n'tu0 I�-1 <br /> u-�a cn��13��- <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> IElectric Gas Other `� z 3�„] <br /> WORK DESCRIPTION f <br /> "7 <br /> 1 ��,.�a,ve 1„z I �,/�-:crc C�,-:�-� -r� I Lia.i <br /> PLUMBING MECHANICAL <br /> NO. I TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> �—` Toilet A/C-airhandling units <br /> I �athtub Forced air systems <br /> = Lavatory (wash basin) Gas piping <br /> _ Shower Waterheater ' <br /> _ Kitchen sink 8 disposal _ Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Cbthes washer Clothes dryer <br /> _ L�,undry tray Range hood <br /> Sink(service/badmop/elc.) Exhaust fan <br /> _ Backflow preventer Heatpump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> Grease trep Woodstove <br /> Roof drains Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this applicalion and know the same to be true and correcl All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether sper.ified herein or not.The granting of a permit does not presume <br /> to give autly�it�to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> con t�tion.ThaTl\am authorized by lhe owner of this property to perform the work for which application is made and I comply with the <br /> St�Contractors Lay�\8 27 RCW and 296.200 WAC. <br /> �L <br /> I Signature of-6wRerlGenkastoNAuthorized Agenl Date <br /> I <br />