Laserfiche WebLink
PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />01 1 <br />PARCEL TAX I.D. # <br />4-�v - 3i3 � - <br />PERMIT # <br />Moral 053 _ <br />LEGAL // LOT N0. <br />DESC. 7J')�) ' <br />BLOCK <br />'r ACTT {�� t \ <br />ti�l�(�/� 1 <br />OWNER <br />ADDRESS CITY/ZIP PHONE <br />TENANT NAME CONTACT FOR P MIT PHONE: <br />DPIif�i� 4? 42. 6?� <br />CONTRACTOR Gy ,fir ADDRESSIp CITY/ZIP PHONE <br />LPL <br />CONTR. LICENSE # <br />USE OF BIT I, : � HEAT SOURCE CONTRACT PRICE OF WORK <br />_Electric was Other 4-M <br />— <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />sink 8 disposal <br />Gas fireplace <br />_Kitchen <br />_ <br />Dishwasher <br />Gas range <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Watei heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />Urinal <br />� <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />drains <br />Other—� <br />=Roof <br />Other <br />CITY OF- EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />construction. Thal Ism ul orized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contract a 177 RCW a 6.200 WAC. <br />Signature of 0 c r/A _ d Agent Dale <br />ill <br />N <br />