Laserfiche WebLink
P�RMIT APPLICATIGN <br /> CITY OF EVERETT PERMIT SERVICES ,(�3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 %� /� � <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org j/(J� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACI:EPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> ysi� S_ri1._ o . St', I �/29�5 ,3�� 5��oa I Cc,tSc,�(-G6� <br /> LEGAL LOT NO. B'.00K TRACT <br /> DESC. / CAi+'I/,j£�'L�l <br /> uwNER ADDRESS CITY/ZIP PHONE <br /> ��p P/�RkC�FfkL� c f.U,��x 9/o C�i.uTti98;�3i 3�a-3vi-�i��Y <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> �¢o /�I9�'k c�Pf£k �� c <br /> CONTR.LICENSE# <br /> F'A�k ���fai��B r�. /��x Yio C��•vro�v 9�;�s� .3l�-3v�-y�� <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> S��(iL £ �/)/�1/L y ,�u'£�l.U� —Electric ,�Gas_Other <br /> 9v ��� <br /> WORK DESCPIPTION <br /> C�•vS7RucTA �t/ w , ,r/G � r � � I <br /> I G �i� fil �c £LLIN� <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> � Toilet A/C—air har.dling units <br /> � Balhlub � Forced air systems <br /> � Lavatory(wash basin) <br /> Sho.ver �. Gas oiping <br /> � Waterheater <br /> � Kilchen sink&disposal �_ Gas fireplace <br /> � Dishwasher �_ Gas ranr� <br /> �_ Clothes washer <br /> _ Laundry tray � Cblhe�dryer <br /> Ranc�r,hood <br /> _ Sink (service/badmop/elc.) :� Exh:.ust fan <br /> _ BackFlow preventer Heat pump <br /> _ Urinal Unit heater <br /> Drinking Fountain Fioiler <br /> � Floordrain �efrgeralion <br /> _ Grease trap Woodslove <br /> _ Roof drains Other <br /> Other — <br /> — — —I <br /> CITY OF EVERETT LOCAL::ALES TAX CODE IS 3105 <br /> I hereby ceriti(y that I have read and examined this application and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces goveming this type o(work will be complied wi(h whelher specified herein or not.The granling of a permit does nol presume <br /> to give authority to violats or cance�the provision of any other stale or local law re�ulaling canstructlon or the performance of <br /> construclion.That I am authorized by the owner o(lhis property to perform tha work(or which application is made and I comply with lhe <br /> Stale C ntractors Law 18.27 RCW and 296.200 WAC. <br /> � �`��' `�-�7- aS <br /> SignaWre of wnedConlrar,todAuthonzed Agent Date �� <br />