Laserfiche WebLink
. • <br /> 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.# P�RMIT# <br /> J C`r'� ��1'�� ��� �l ����-� �L.%�7CC�� ���%'__� � � � <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. �• <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> GG'�/1�' ��t°�� l���Yr��'��" �'� `�`�7 �it�> c����/� WtE ����`� <br /> TENANT NAME �/� CONTACT FOR PERMIT -� ���PHONE ���L' <br /> LGTW�c� T �.��✓�/� �i/� i���� /�/��i��L%v��� E-MAILI�<��'f'1���G-��,r1ttics ii�.4� <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE � <br /> CONTR.LICENSE# � 1� � ��� ��� �1, l 1 � ,�7� �I(� � /�'i //'� <br /> / � ��l� O/L <br /> USE OF BUILDING Q���i2�C HEAT SOURCE CONTRACT PRICE OF WORK <br /> 1 v//��f j✓ <br /> _Electric _Gas_Other �������' <br /> WORK DESCRIP�ION / r <br /> ����� � ����`% 1����'l',1�C'�1.�� -�v GlCE^.�`is�1✓�-�l�fC ��'�Ir/� <br /> ����. <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 freplace <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 /> I 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 author -to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> constructi That am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Co tra L 7 RC .200 WAC. <br /> - (i:> � �? <br /> S nat e of Owner/Contractor/Authorized Agent Date <br />