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 8 AM TO 4 PM <br /> SITE ADDRESS aa16 `W" PARCEL TAX I.D.if PERMIT#_ CVfr�ett W �S7(03 OU I b ( -cJU-�- <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION p <br /> OESC. / '1 60 Vje�j / (.JA1 [� q / ry1 <br /> OWNER/) ,Id� ONE <br /> xm ( � P� �" C /IAI/tll lQ,i3 0 kS 34,E <br /> TENANT NAME TA CONTACT FOR PERMIT PHONE ({ h5 3y 3 a <br /> / I E-MAIL � <br /> CONTRACTOR ADDRESS <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> rr'� 4 Electric _Gas_Other <br /> WORK DESCRIPTION Te-6JI(AU M r <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower i Water heater <br /> ( Kitchen sick&disposal Gas fireplace <br /> L Dishwasher Gas range <br /> I Clothes washer I _ Clothes dryer <br /> ( Water healer )c_ Range hood <br /> _ Sink(service/bar/moplaic.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> _ <br /> Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Arigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> 1 hereby ceritify 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 ammauthorized by the owner of this property to perform the work for which appiicabon is made and I comply with the <br /> o tr <br /> 8. <br /> 720 <br /> Stale Cs olntrecto-rl utho d WAC. <br /> Agent 2 ?4-'-OR <br /> Sig turr3of w5e <br /> Z <br />