Laserfiche WebLink
PEF�I��IT APPLICQTION �2-� �-a� <br /> CIYY OF EVER��f PERMIT SERVICES <br /> 3200 CEDAR STRCET, EVERETT, WA 93201 <br /> 425-257-8810 - f'AX 425-257-8857 -www.evc rettwa.org <br /> ' 7D� APPLICATIO?7S ARE ACCEPTED FROM 8 AM TO 4 PM �nf/�-�Q9 <br /> �u <br /> SITE AUDRESS PARCEL TAX I.D.# PERMIT# <br /> -� �3�" S�-• oo�i385-Z4{o^000-oe��o��nZ) o 08-� <br /> LEGA LOT NO. BLOCK TRACf OR SUBDIVISfON# <br /> DESC. <br /> OWNER A�DRI:SS CITY2IP PHONE <br /> �K�/�1�NC� E1�R.SIr H6n L7ft- I�zl Gol�/?� EV�R�If �B,ZoI,. (�'LS�ZL1-455 <br /> TENANT NAME CONTACT FOR PERh1 PHONE 2,53'g3-3"A�Z4S I <br /> Tryc�+� ��S E•MAIL-I-�2{q.�Q++CCY�1T {w7.S}• <br /> CONTRACTOR ADORESS CITYIZIP PHONE I Ger.. <br /> PIL-E 5�'j�''S tici�ST 1�� P-Ct'-�'iA�E. RA, PAc-+P7t��WA 253-833 � IZ48 <br /> CONTR.LICE E k ��TE G aj$04'� <br /> F�� swz �+flB� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> M�DIC.oI.� ___Electnc __Gas_Other �Z-�baa�eaD <br /> WORK DESCRIPTION <br /> J Al$'tALI. �a Ftf-� SPA�-I1JK-I.SaQ- Sy'S'1�A^S 3'T" L.f:1�L.S r'J - R86� <br /> l'lJ 1-rE'{�,� l2' �"R- Bt�c.,' <br /> PLUMBING MECHANICAL <br /> NJ. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilel ._ A!C-air handling units <br /> Bathtub Forced air syslems <br /> _,_ Lavatory(wash basin� Gas piping <br /> Shower Waler heater <br /> Kitchen sink 8 disposal Gas fireplacc <br /> Cishwashcr Gasrange <br /> Clolhes washer Clolhes dryer <br /> Water healer Range hood <br /> _ S:nk (service/barlmop/elc.) Exhausl lan <br /> _ Backflow preventer _ Heat pump <br /> Urinal Unit healcr <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> i Grease Irap Woodstove <br /> _ Rooldrains 28S] OthCr�'{n� <_PQ.e,Ak1,FR-S <br /> Othcr _ . ._ --_ - . <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 hereby ceritify Ihal I have read and er.amined this applica�ion and know Ihe same�o be irue and correct. All pwvisions of laws and <br /> ordinaces goveming this type of work wili be complied with whelher specificd herein or nol The granling of a permit does nol presume <br /> to give authoriry ro violate or cance provision o(any other;tate or local la�v regulating conslruction or the performance of <br /> conslruction.That I am authorize b the owner of this property lo pedorm Ihe work lor which application is made and I comply with the <br /> Slatc Coniraclors Law 1827 ft�W�and 296.200 WAC. <br /> / <br /> �f�_ I l�19�0� <br /> SignaWre ol OwnedCon ac r/Authorized Agenl '�-D�e <br />