Laserfiche WebLink
PERMIT APPLICATION <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 fl _1 7 -0 <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />/S-/5" ZrJ "A Sf &rC"e1f <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION # <br />DESC. I <br />OWNER ADDRESS CITY/ZIP PHONE 5/Zs- -50% -5-8a' <br />Sii��^� /716Er7rS 94117 6G ylti l�r. NL. YGf(sv e 9uz�U <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE yL 5- 77 Z -3i6 <br />/ <br />) .ya.�CGr drlc/: <br />I <br />E-MAIL <br />CONTRACTOR<,U/� LC✓�� �ris+.�rtt ` ADDRESS y9�� t✓�/ S /2VLAI YiZIP CLONE <br />S!?✓IIISN R ✓l 9`Kz9� <br />CONTR. LICENSE # <br />%yi�GcG 9&Z- <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />I <br />Lc Electric Gas Other <br />7, SO l/ ' <br />I — <br />WORK DESCRIPTION���r`L J <br />i <br />I <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C —air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />Shower <br />Water healer <br />_ <br />Kitchen sink & disposal <br />_ <br />Gas fireplaze <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />_ <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boiler <br />_ <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodstove <br />_ <br />Roof drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Stale Contractors Law 18.27 RCW and 296.200 WAC. <br />Signalurg,of Owner/ContractorlAUthorized Agent Date <br />