Laserfiche WebLink
PERMIT APPLICATION <br /> CITY Of= EVERETT PERMIT SERVICES �_� 5 _� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-SE310— FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � /l/l`l' '�i� � <br /> SITE ADDRESS PARCEL TFU(I.D.� PERMIT# <br /> '�o�; ; 15''' �T �����r �.�,A 953Zv) "?�i���7 27`� o0 2oif �-���['�/,> �-/l';G <br /> L[GAL LOT NO. BLOCK TRACT OR SUBDIVISION d G VP1G`F AI V T 14I,� <br /> DFSC. Z. 27 %-ot � o� c-�,iY�f 5v�re�t ���' �2o�-i 7-R3 AF I� `f7'�,:� <br /> OWNER ADDRESS CINIZIP PHONE p <br /> �`"�5��� SCJ�'.i15�'�1 ?��'-, ��'" >1� EUP�t��`��� �.o�'7d3'H��� <br /> TENANTNAME CONTACTFORPERMIT PHONEZO(p-y`a7j`�tZYT� <br /> I �Jl.7[' �(j <br /> �SJI�`15t'/� E•MAIL��SCI���t1Sm�'S�'1'1.�,I�:cY� <br /> '�A7�j� � Ft �TI YT11P � <br /> ,:,,�� � yy ow����r <br /> CONTR.LICENSE it <br /> USE OF BUILDING HEAT SOURCE �CONTRACT PRICE OF WORK <br /> I� {-,,,M�I1/ (�P:��i���cL � � <br /> S"��� J _Eleclric ,�Gas_Olher � l� �' �� <br /> WORK DESCRIPTION \ �ic�� ��'"wC-� V�'�'�'�' �� <br /> r� _.vl��� ��1Gi5T(� L'4'�f�"NI <br /> l�~ ��1} � ��r��� <br /> . _�`e z <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � �� '. Toilel WC–air handling units <br /> i Bathlub Forced air systems <br /> i'�. Lavatory(wash basin) _ Gas piping <br /> � ,'� Shower ... Waterheater <br /> �` Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> 'Naler heater Ranye hood <br /> Sink(servicelbadmop/elc.) _L Exhaust fan <br /> Backflow prevenler _ Heat pump <br /> Urinal Unil hea�er <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeralion <br /> Grease�rap _ Woodstove <br /> Roof drains Olher_ _ <br /> Other —_ <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined lhis application and know Ihe same lo be irue and correcL All provisions of laws and <br /> ordinances governing this rype of work will be complied with whelher specified herein or nol.The granting of a permit does not presume <br /> to give authority to violate or cancel ihe provision of any other slale or local law regulating construction or the performance of <br /> consirudion. Thal I am aulhorized by Uie owner of this properly lo per(orm lhe work for wnich applicalion is made and I comply wilh the <br /> State Conlrac:ar6 Law 1827 RCW and 296.200 WAC. <br /> � � �� . ....___ ----- � <br /> �;j _ _ _ � S �5-t�. <br /> Signalur¢of OwnedCoTtrzc�odAuthqnzed Agenl Date �� <br /> � - <br /> � — -L <br /> �------ --- — — -- <br />