Laserfiche WebLink
P�RMIT APPLICATIGN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C/�UI -��' <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I�,r -� <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT# <br /> ��' ��/r > ���� ./�l� !.� f���S�z C��C�L �l�/�'� � - <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OY✓NER ADDRESS CITY/ZIP PHONE <br /> - ��^Je, �/� F�/u � �� ��'y-/�' / s ��. ��tie l�/ �tir��i�i l�A 9 '�� , <br /> TENANT NAME CONTACT FOR PERMIT PHONE Z�J�._� �p — O <br /> S�l�-�O/J yL� E-MAIL�I/��C/J��oz3�l7�T/�A�( c�'`� <br /> CONTRACTOR ADDRESS CITY2�P PHONE <br /> CONTR.LICENSE# . ' <br /> USE OF BUILDING �"� /�', - HEAT SOURCE CONTRACT PRICE OF WORK <br /> /' I � ��T ,T��%'ll \ <br /> �`�� �j�j,!/�/T1)L '" / _Electric _Gas_Other <br /> WORKDESCRIPTION����� � �� �������� E)����� <br /> /�/�-� 8 s� <br /> .7 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilel A!C-air handling unils <br /> Balhlub Forced air systems <br /> Lavatory(wash basin) Gas pipiny <br /> L Shower VValer nealer <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwaslier Gas range <br /> Clothes washer Clothes dryer <br /> Waler heater Range hood <br /> ( Sink (service/bar;mop/elc.) Exhausl fan <br /> Back(low preventer Heat pump <br /> Urinal Unit heater <br /> Drinkinc� Fountain . Boiler <br /> Floor drain Re(riyeration <br /> Grease trap Woodstove <br /> = Roo(drains = Other I <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA�'CODE IS 3105 <br /> I hereby ceriti(y thal I have read and e�;amined Ihis applicalion and know Ihe same to be true and correcL All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whelher specified herein or noL The granting of a permit does not presume <br /> to give aulhorily lo violate or cancel ihe provision o(any other slate or local law regulating conslruclion or Ihe performance of <br /> construction.Thal I am authorized by Ihe owner of Ihis property to peiiorm the work for which application is made and I comply with the <br /> Slale Conlractors Law 18.27 RCW and 2�J6.200 WAC. <br /> %i*i �`�/�/�-Y-t-�' � � � <br /> Signature Owner Contraclor/Autliorized Ac�ent al� ��, <br /> / <br />� - <br />