Laserfiche WebLink
I- ERMIT APPLICATIvN <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 PARCEL TAX I.D.tt PERMIT 0 <br /> IDE' 77yP64ae SW OoG4SocT0000 Zoo 4:9119 <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISIONS <br /> DESC <br /> OWNER ADDRESS CITYIZIP PHONE <br /> G U-ZMAM f)C 5607SOALd &20f 480 10010 2S Ir-1 <br /> TENANT NAME CONTACT FOR PERMIT 6WIL" /S PHONE^zpi, y Z 3 Y4•7q <br /> PAUL I DAUE oy�- da� �I{ ' EMAIL JvD <br /> AEC 20,VE7+ T,t> <br /> Z'i5A f — <br /> CONTR.'_ICENSE 0 3 <br /> USE OF <br /> BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Ick.S10G�� /'Electric _Gas_Other <br /> WORK DESCRIPTION <br /> (ZEhwVE ATTAT-CHISO CLorep IN pao(LCA . 12HW4LL ltou5et t ATrti i& TD IT'S <br /> C)I?I INAL srm-e . !°eon 3a <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) NpN E Gas piping <br /> _ Shower Water healer _ <br /> _ Kitchen sink 8 disposal Gas fireplace N0N C <br /> _ Dishwasher Ges range <br /> _ Clothes washer Clothes dryer <br /> _ Water healer Range hood <br /> _ Sink (servicelbar/mop/etc) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> _ Urinal Unit healer <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> 1 hereby certify that I have read and examined this application and know the some to be true and correct. All provisions of laws 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 properly to perform the work for which application is made and I comply with the <br /> State Contractors Lew 18 27 RCW and296200 WAC. <br /> Q--y . � I- S- 10 <br /> Signature of Owner/ConliaCtollAut ionzed Agent Dale // <br /> Z <br />