Laserfiche WebLink
11 <br />11- <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />L6go 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. # PERMIT # / <br />G0-7 Y 6c93 <br />LEGAL LOT NO. DLOCK TRACT <br />DESC. <br />OWNER DDRESS ITY/ZIP PHONE <br />OWNER 3,4l')( <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />1 <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />Ehclric Gas Other <br />WORK DESCRIPTIO <br />ram,, a aw�,,.,� <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE )R 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 />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clulhes dryer <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow prevenler <br />_ <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br />1 hereby corilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />erdinaces 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 can mvision of any other slate or local law regulating con:truclion or the performance of <br />conslructl u odzed by a owner of this pmpolty to perform the work for which application Is made and I comply with the <br />S,tn ontrac w CW d 296.200 WAC. <br />o/a�le%C1'� <br />Signature o e nlractor/ hodze� gem <br />t3 <br />