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.evereftwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM so,1 S <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT K <br /> /q/0 � 57. 5W. "F oIo668o0200600 y0� OG1S <br /> LEGAL LOT NO. �l RLOC TRACT OR SUBDIVISION N <br /> DESG. _ (' J?t gct. — <br /> OWNER ADDRESS CITYIZIP PON <br /> _r2s2o7-9r4� <br /> k cluar T�Nn �r t (3�.1�or..ct IIF,28r OlyAr< 4.K! 5 91,41,H Tek.. (� 1✓A gtt`6K <br /> TENANT NAME /CONTACT(FORIPERMIT�^ ry1 /^, PHONE o�1 <br /> ,.-.; 4,Cr.1'� ICL-l.Sl o4 Leer (– uet Z5J \l�s)77J - C)y <br /> COITRACTOR ADDRESS CITYIZIP PHONE <br /> Re'rty AU ,c s S J., Sys4e. 6 TIM NoAeso,% RoaJ Cuereiij WA `78?Oj <br /> ONTR.LICENSE M <br /> �ERRYNC-07 7c AA 605)776-W35 <br /> USE OF BUILDINGI HE.'.T SOURCE I CONTRACT/PRICE OF WORK <br /> C « I _Electric Gas Other <br /> WORK DESCRIPTION <br /> T.. o.ne (1) cxxL h 2' s "It ts'•u 't 110A We-,cE <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 Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(servicerbor/moplaic.) Exhaust Ian <br /> Backllow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Bailer <br /> Floor drain Refrigeration <br /> Grease Irap WoDdstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 /> ordinator ,jvorning 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 Lew/18.27 9CW an 298.200 WAC. / <br /> ����A, �� <br /> S gnaturo of er/Con factor/ u1 orized Agent ala 1/Z <br />