Laserfiche WebLink
PERMIT APPLICATION <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 B AM TO 4 PM <br />SITE ADDRESS <br />50.5' ✓03�gi.. S&' <br />PARCEL TAX I.D. # <br />PERMIT # <br />I rML(1 qq1- <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />061)1A15 �MME `t/VR-C— i `(2S' -f26)- `j2/b <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />�riR2Y�iN��� 0206-�SS�7b'S'S <br />CONTRACTOR .= ADDRESS Cl ,26 ClTYIZIP. / PHONE <br />CONTR. LICENSE # A/) RDrdL pn&T <br />CJ1 (U6 <br />USE OF BUILDING/ <br />HEAT SOURCE <br />CONT ACT PRICE OF WORK <br />_ Electric )�GaS _ Other <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 />— <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />_ <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />Backllow firm enter <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />WDodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 hereby coritify 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 typo 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 state or local law regulating construction or the performance of <br />construction. Thal I am authorized by the owner of this property to putform the work for which application Is made and I comply with the <br />Stet ontraclorsLL !1.27 RCW and 296.200 WAC. <br />Signature Owner/Contractor/Authorized gent Date <br />