Laserfiche WebLink
PtRMIT APPLICAT16.4 <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 ZJ . a ��!/ <br /> C✓Ell 'r <br /> ITE ADDRESS PARCEL TAX I.D.q PERMIT p <br /> 1 G' 16 «, S I S c c) /17/11( 2 <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. i C <br /> OWNER ADDRESS CITYIZIP PHONE L,tZarJ3ZZ-iiC d <br /> 6u6AcaR2 `Sra6 tG 1ln 7b14 si S w EvL !ec-7j Lia 4 203 :ggElod) 77 -3V4 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> EMAIL <br /> CONTRACTOR ADDRESS VIZI <br /> CONTR.LICENSE 0 f IC'oe-Tr <br /> USE OF BUILDINGI — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> 1kl'ew�f <br /> PLI-IN G 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 Water healer <br /> _ kitchen sink&disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> _ Water healer Range hood <br /> _ Sink(service/bar/mop/etc.) _ Exhaust fan <br /> _ Backgow preventer _ Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain — Boller <br /> _ Floor drain _ Refrigeration <br /> _ Grease trap _ Woodstove <br /> _ Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I hereby cerlify that I have read and examined this application and know the same to be true and correct All provisions of taws and <br /> ordinances 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 Contractor LeJ11 7 RCW and 286200 WAC. <br /> Signature of Owner Contractor/ ul o ed Agent Dale <br />