Laserfiche WebLink
PERMIT APPLiCATI�N <br /> CITY OF EVERE7T PERMI7 SERVICES <br /> 3200 CEDAR STREET, EVER�TT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 7,���� � 7 <br /> SITE ADCRESS f PARCEL TAX LD.A P�R� <br /> 2o2.rr> 1.A�e D�•� •� 2&�529a�Zr1z� Bo � ,�- - `t <br /> LE LOTNO BLOCK TRAyC�Tp , IL_ <br /> DESC. q Q�Pin S ����fQ�1/ !�V K. � <br /> O/WNER ��� /-j� ADDRESS C(TYlLP PHONE <br /> '7�I� N'�hi �Vl3'7( l�W �1� `7uM �O �'M+ � J��d'� �I Y� <br /> ���NAI�`������ CONTACT FOR PERMR PHONE <br /> � � � Ml►� ,d�r"�+� ¢� • ����dl�- <br /> CON DR ADDRESS CfTYlLP PHONE <br /> �� L�arr�v► 23�5 • 13a� ,4,rc h�E &.Ucixx., qZs'•�a9•4o4ca <br /> CON'fi2. ENSE/ *��� � �� �A_�yr� <br /> rr �v�... <br /> USE OF EUILDING HEAT SOURCE aNTRACT PRICE OF WORlC <br /> � � � Q'l� <br /> �"�A��l1Mt� _vElectric _Gas_Other � �// � <br /> WORK DESCRIP'TION <br /> �kfWtv� 1'G-Sl� t yl�Ii�S � ��G�i�S <br /> PLUMBING �,/ � MECHANICAL p/ �., <br /> NO. TYPE OF FlXTURE OR(TEM NO. iYPE OF FU(TURE OR REM � <br /> Tdlel AIC—air handlirg units <br /> Bathtu6 Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> � Shevrer Water heater <br /> Kitd��n sirk 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry lrey Range hood <br /> Sink(service/barlmop'elc.) Exhaust fan <br /> Backflow prevenler Heat pump <br /> Urinal UnR heater <br /> Drinkirx,�Founlain Boiler <br /> Floor drain Refrigeration <br /> Groase trep Woodstwe <br /> Roof drains Other <br /> Olher <br /> CfTY OF EVERETT LOCAL SALES TA%CODE IS 3/05 <br /> I hereby ceritify that I have read and examined this applicatloi;and know the same to ba Wo and correc,i. NI pmvisions of laws and <br /> ortiin goveming this C+pe of walc will be compliecf with whother spedfied herein or not.The grantirg oP a pertnR does nol presume <br /> ;�give a 'ry ro violeta or cancel the provision of any other state or local law reguladng consWdion or the peAormance of <br /> construction. at m autliorized by the owner of thix property to perfortn the watc for which applicatlon is made and I compty with the <br /> State Contract CW 2nd 296200 WAC. <br /> -c.�_ � 2.3 Q� <br /> Signature ol onVaclorlA thorized Agent Da � <br /> �t <br />