Laserfiche WebLink
PLRMIT 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 8 AM TO 4 PM <br />SITE ADDRESS Tel <br />PARCEL TAX I.D. A <br />� <br />PERMIT N <br />/r57 75s,— s� <br />n1 //oniao�n^ <br />trio-o/> <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITYIZIP PHONE <br />/�-o/ Ner7h 7no at 4of.;j <br />�vy <br />76-Th5 % C�lJrk2 L) �, a washHwten L rv„irt<d l t�6�L.7� ca,t,j <br />TENANTNAME <br />CONTACT FOR PERMIT P <br />T <br />Ifp <br />I /'11Ck1%cL WAAI q�S-870-(e0-7 <br />r i71C I✓pGik,c/ <br />CONTRACTOR ADDRESS M CITYIZIP PHONE <br />Cl.ay.,o..Ts Gener.►L Cen.T,JNr /5WOt; sF2G4 S7 e-oJ��yTon�4e a�3-63/-9/06 <br />CONTR. LICENSE N CLrnslr�C. O SOO 'Sr- 99o,{y. <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />f3,,,Ls;�y <br />idSTrv�cro,r�FL. <br />%D O/ 0 0 0 <br />I I <br />— Electric Gas other <br />WORK DESCRIPTION <br />1—cI,Aiv7" 1kit Crcrrr- T-- 9ar <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 />_ <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas Tango <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />_ <br />Sink(service/bar/moplete.) <br />Exhaust fan <br />_ <br />Backflow proventer <br />_ _ <br />Heat pump <br />Urinal <br />Unit healer <br />_ <br />_ <br />Drinking Fountain <br />Boller <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstave <br />Roof drains <br />Other <br />_ <br />Other <br />�'r Go �a n ss �✓ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 hereby ceritily 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 state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />on <br />Signature o nor1Gonlractor/Authorized Agent ^� Data <br />