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 />_SATE ADDRESS <br />1 ,4 ,PARCEL TAX I.D. p PERMII A <br />I <br />�1 IU e-1 t&k <br />. Sit- �Jcw_ \ W-D IOl 7' -O 0/ <br />LEGA LOT NO. <br />BLOCK <br />RACT OR SUBDIVISION p <br />DESC. <br />OWNER ADDRESS 11 I CITYIZIP PHONE � <br />(Z- <br />a �a �1 . I O ^ !F�) `i . , �--- . lffy e—j - tnl.3 <br />TENANT NAME <br />I CONTACT FOR PERMIT PHONECA,j�1 3� <br />E-MAIL <br />CONTRACTOR CITY/ZIP Alm <br />CONTR. LICENSE 0 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />I — Electric _Gas Other <br />— <br />WORK DESCRIPTION /� <br />1 .�fV <br />�o <br />PLUMBING <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR 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 />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />_ <br />_ <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (servicelbar/mop/etc.) <br />Exhaust fan <br />_ <br />BackBow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boller <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />1 hereby certify that I have read and examined this application and know the same 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 pedcrmance of <br />construction. Thal I�9uIh y the owner of this property to perform the work for which application is made and I comply with the <br />State ContrSdo� w-38 2I RC and 208.200 WAC. <br />C - 0 <br />ignature of Owner/Contractor/A t odzed Agent ate <br />11 <br />