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 /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> /-6,2- � lie <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE: <br /> TENANT NAME I CONTACT FOR PERMIT S HOS 5X 9� <br /> E-MAIL J�7-> <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE: <br /> CONTR. LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> 1 r � <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 &disposal Gas fireplace <br /> Dishwasher Gas range <br /> /__ Clothes washer / Clothes dryer <br /> Water heater Range hood <br /> Sink (service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <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 3105 <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 perm t does not presume <br /> to give authority to tiiolate or cancel the provision of any other stateor local law regulating construction or the performance of <br /> cqnstruction. That I am authorized-by the owner of this prop rty o perform the work for which application is made and I comply with the <br /> St'�te...Contradtors Law 18.27 RC and 296.200 WAC. <br /> •l' <br /> l � 2- - � � <br /> ignatUr f Own er/ContractortAu onzed Age Date Date <br />