Laserfiche WebLink
, <br />PERMIT APPLICATION <br />C17Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />4'�.5• 257-8810 — FAX 425-257-8857 — �nnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SITE ADDRESS ' PARCEL TAX I.D. # PERMIT # <br />�j'Sl N B�cada�� G�F��tl" c ycsi ��-oz����o � lcr�-7-Z�,L.� - <br />LEGA LOT NO. BLOCK TRAC'f OR SUBDIVISION p <br />DCSC. <br />OWNER ADDRi=SS CITYIZIP PHONE <br />P�: M �1 a.� �+'JeK�t?/� <�-/5 S' C�o utc Ca u � t 1�f Glk��l �ee�� `��� 3�3 3Z3 � <br />`�y� _ <br />TENANT NAME f,CNT^ CT FOR PERMIT PHONE . <br />// i�'Dl� � 'h,-iN(a MC'OG'S Zv(—'�"l ^�95�� <br />� ` _.. E-MAIL h1aL�t �'E`jl Q�-ma��I�.t <br />U� 11 E� <br />CONTR. LIC[NSE # <br />USE OF BUILDING <br />� <br />l� C j-u/ � <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />,� Elc:tric _Gas_Other <br />VYORK DESCRIPTION <br />,U t���ublc dt�ois i �, n� GucK c f l����/,.l.b. <br />r-, � <br />PLUME <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bath�ub <br />_ Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/badmop/elc.) <br />l�ackllow prevenler <br />Urinal <br />Drinking �ountain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Other <br />NO. I TYPE OP FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas -ange <br />Clothes dryer <br />Range hood <br />Exhaust :an <br />Heal pwnp <br />Unit healer <br />�oiler <br />Refrgeralion <br />Wcodstove <br />019er <br />CITY OF EVERE7T LUCAL SALES TAX CODE IS 3105 <br />I hereby cerlify that I have read and examined this application and know the same lo be true and correct All provisions of laws and <br />ordinances governing ihis type of work will be complied with whether specified herein or not. The granling of a permil does not presume <br />to give authority to violale or cancel lhe provision of any other state or local law regulating construction or the performence oi <br />construction. Thal I am authorized by the owner of this property lo pe�iorm lhe work (or which applicalion is made and 1 comply wilh the <br />Stale C%o it�ac� rs Law 1827 RCW and 296200 WAC. <br />/ ��/ i,r—�n i• -�J 71 L�r� '� �9 / / o <br />