Laserfiche WebLink
P�RMIT APPLICATIC�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org D � � `"�"7 _ j C I <br /> I" '1 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTcD <br /> SITE ADDRESS PARCEL TAX I.D.# ERM�T# <br /> �6 Sf`',�„SC �i�iv� �� � � �soo �-JoI - 7 <br /> LEGAL LOTNO. BLOCK TRACT � �� <br /> DESC. /S <br /> �� <br /> OWNER ADDRESS CITY2IP PHONE <br /> ��o �°�C��C�c C'/-��x�io G�.-�„ r�z,� v�zs--z.�� �2 Z � <br /> TENANT NAME � CONTACT POR PERMIT � PHONE <br /> SDEc ��' � � ,�}�-. -�y' <br /> / • ` j1 � �i rr�-e!" �d7�i 5<Zs z3s� 2'z 7► , <br /> ONTRACTOR ADDRESS CITY2IP PHONE <br /> 4U /�e���«< • • � <br /> , • , , � ;, . <br /> C6NTR.LICENSE# /a./ •.� . � <br /> ��.c.K<x� a,Z < a P�G TeX9i� �Xti.�a.> ys�6 5�-�s=z3� s�2y <br /> USE OF BUILDING HEAT SOURCE � CONTRACT PRICE OF WORK <br /> � ��s ��� I _Electric �Gas_Olher I �5/ U U U <br /> W RO K DESCRIPTION � <br /> /K '� �'"Q'''-P J-�+.,� ��� <br /> _ I <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> a Bathtub � Forced air systems <br /> 3�, Lavatory(wash basin) � Gas piping <br /> �_ Shower �_ Water heater <br /> _L Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher � Gas range <br /> � Clothes washer / Clothes dryer <br /> _ Laundry tray 7 Range hood <br /> Sink(service/bar/mop/etc.) �� Exhaust fan <br /> � Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I I i hereby ceritify that I have read and examined this application and know the same to be true and correct. AII provisions of laws and <br /> ordinaces governing this rype of work will be romplied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty to vioiate or cancel the prcvision of any other state 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 /> State Cor�tractors aw 18.27�W. nd 296200 WAC. <br /> l�'��.�,��� 7—�—os� <br /> Signature of OwnedContractorrAuchorized Agent Date ��Z <br />