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 <br />PARCEL TAX I.D. # <br />P MIT # <br />��IC E�1tRC)ZEtIeWAy w1-11,$ <br />G�111�CLcc30 <br />zazl <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />C�IGMN�I� ,DKVII) ): I�11h v� I N Si JL EVLILLTT/9ti2'b <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />EALILL CASH K\LVW-9 JI . I`Iny�l'���r-r lUZ0 3`)) -4bb2 <br />CITYIZIP PHONEIJP��'/JcO�(j% <br />CONTRACTOR �ADDRES <br />�p CONTR. LICENSE <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />09 L�`f;Q_ �)�L(h(;SSIOunI. )`IL'iNLL <br />—Electric_Gas_Other <br />Vat"ICoo <br />WORK DESCRIPTION <br />\v) <br />�NSi/�LLATIuIJ GF hl�py :11- Ji 1., I w`j) . 0 (. II VCTIvQ Ce WICL- aNP ?J YX nj -L <br />�11t-`t`t�N pMaEts. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />_ <br />Gas fireplace <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Water heater <br />_ <br />Range hood <br />_ <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow prevenler <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Floor drain <br />Boiler <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />_ <br />Woodstove <br />_ <br />Roof drains <br />_ <br />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 />ordin governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to giv thoril I to violate or cancel the provision of any other slate or local law regulating construction or the performance of <br />construe on, T at I am a thorized by the owner of this property to perform the work for which application is made and I comply with the <br />State C ntra t rs 18 27 RCW and 296.200 WAC. <br />; l zl I off, <br />Signature of Owne /Co acttor Authorized Agent Date I/Z <br />