Laserfiche WebLink
P`RMIT APPLICATI( J <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 /> 7 - a6-os <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESSx 3CDCD -R VC_IEl L LG(I PARCEL TAX I.D.# P,I RMlo 7 - <br /> v(&,- <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> SK(CA-40N\\31-1 C 0UOT - <br /> TENANT NAME D L 0 / CONTACT FOR PERMIT PHONE <br /> Ao,vi 1 t,.t\ 5T2A11-10%\1 'i3 c :V� [3.ZOW>J (F. °I`").--7.7? — 27 1 <br /> CONTRACTOR 11110Q-1.1:1:-. N So t. i ADDRESS CITY/ZIP PHONE <br /> 3t_ 1-) ZOCCEit-L.cY/.._ �Z�1 ���Z�� <br /> CONTR.LICENSE# 1-, C CE,T '\l� c go;/ / <br /> USE OF BUILDING CJ•�HEAT SOURCE Y C1 V CONTRACT PRICE OF WORK <br /> VT-(--t C:C 5 (C —Electric _Gas Other <br /> WORK DESCRIPTION <br /> at(L. Dc az, ock r - -x t Sl 1'v L7 a."( LO f Ase) V-(/AJELJ pAlt-rt`7 ,_\,L.) <br /> \t(kLLS , 5c-/Lec_t KLE 00L-kS <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. T)PE OF FIXTURE OR ITEM <br /> Toilet NC-air handling units <br /> __ Bathtub Forced air systems <br /> •• Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink& disposal Gas fireplace <br /> Dishwasher Gas ra Igo <br /> Clothes washer __ Clothes dryer <br /> Laundry tray Range hood <br /> Sink (service/bar/mopietc.) _ Exhaust fan <br /> Backflow preventer Float 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 ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces 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 authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> Nod construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State nir ctors Law 16.27 16.27 <br /> �RCW and 296.200 WAC. / <br /> ig -7( a(G0c <br /> Signature of Owner/Contractor/Authorized Agent Date ‘(2- <br /> .- <br /> . <br />