Laserfiche WebLink
PERMI'T AF'PLICA�ION <br /> CITY OF E!/�IRETT PERM{T SE�VICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 4?5-257-8810-FAX 425-257-8857-wvvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM � - 3� -O� <br /> SITE ADDRESS � PARCEL TAX I.D.t PERMR* <br /> 2D2ca La� R'•� 2'&�52`i a�2dz� R , -�:�; `i <br /> LEGAI LOTNO BLOCK 7RAC�Tt�p� I ' L_ ,y <br /> DESC. q Q�V'���S �j�IV'Pa/ INVK. 1`7 <br /> pyyNER ADDRESS CfiYltlP � PHONE <br /> �i i 6u�,v Galti +�tyk�,, �t,L ('1l�f- Su�. � � �S�w D�c{g�,C� <br /> TENANTN E CONTACTFORPERMR FHONE <br /> t��k �Gt(���'�, I� �►'Ilwa�c �d�c. � • 2r��?�fd I�-- <br /> C TOR ADDRESS CRY1TlP PHONE <br /> �.:av�� 1�'G�l�N 23�15 ' �io1� �(ttG j�E BGl(cp�p��� �fZS'•2�T'4o�t� <br /> CONTh. E�NSES *�FL�'�'y�.� �t/Vf� ZOD Wpr Lr""� <br /> ����J <br /> USE OF BUILDING � �HEAT SOURCE ONTRACT PRICE OF WORK <br /> �V'` �l:�M��a I _vElectric _Gas_Other � �// �� 6� <br /> WORK DESCRIPTION <br /> �fU�lov f'�-5l� t ��fi�s � �l,o�lf�5 <br /> PLUMBING �,/ � MECHANICAL p/ �_ <br /> NO. TYPE OF Fl7(TURE OR fiEM NO. TYPE OF FU(TURE OR REM <br /> � <br /> Tdlet A/C—air handting units <br /> Bethlub Forced air systems <br /> Lavatory(wash basin) _ Gas Piping <br /> Shower Water heater <br /> IGtchen sink&disposal Gas firuplece <br /> Dishwasher Gas range <br /> Clothas washer Clothes dryer <br />- Leundry Uay Range huod <br /> Sink(service/badmopJetc.) Exhaust fan <br /> Backflow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain B�iler <br /> Floor drain Refrigaration <br /> Grease 4ap Woodslove <br /> Roof drains Other <br /> Other <br /> CfTY OF EVERtTT LOCAL SALES TA%CODE IS 3105 <br /> I hersby coritify that I have read and examined this applicatbn and krx�w tt�e same ro be true and cortuct. Ail provisions of laws nnd <br /> ordin goveming ihis lype o(wak will be complied with whather spedfied herein or not.The grantirg of a permit does rwt presuma <br /> to give au 'ty to violate or cancal the provision ot any other sta�e or local law regulatlng consWdion or tlw periomiance of <br /> consWction. at m autlwrized by tlie ox�ier of this property to perfortn the worfc for which application is made and I compty with the <br /> State Contrad ^ CW anQ 296.200 WAC. 2 <br /> � �J <br /> Signature o ' ontractodA thorized Agent Da <br /> �/� <br />