Laserfiche WebLink
P�RMI�" APPLIt;.ATfC�N <br /> CITY C)F EVE�ETT PERN1!'T SERVICES <br /> 3200 CEDAR STREET, EVE^�IT, WA 9820' <br /> 425•257-8810 - FAX 425-257-8357 -www.everett�.aa.org <br /> APPLICP,TIONS ARE ACCEPTED FROM 8 AM TO 4 ��M <br /> SITE ADDRESS � PARCCL TAX I.D.# PERMIT# � <br /> l �ab �( � CT�`�5a�olbo�4c.� Cn� � -o�,'� I <br /> LEGAL LOTNO./ BLOCK TRACT <br /> DESC. -..)�I GL�Zc� <br /> OWNER AD�RESS CITY/ZIP PNONE <br /> 1�Ft��� l��° v�> I�piti, ��" �o� ,� Col� IW� S�e �v� L���e�,-� ��s �vi <br /> TENANTNA�dE CONTACT ORPERMIT PHONE <br /> �-va�� I 13�1 l �,�i�i _ �r a�6 3G� �a�+5 <br /> CONTRACTOR �55UC1���'�I `'�w �1 1�1� ADDRESS ��O� �c *�',� q� CI�21P PHONE <br /> .� 1 ry^�v�nCi1'e..' �t50)S ,�(�f, 3i.�`l'�t <br /> CONTR.LICENSE# ���xKZ �G.�O� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRAC'- PRICE OF WORK <br /> �/�.���/1},�f Eleclric Gas Olher t(-��r � <br /> WORK DESCRIPTION <br /> C'��1-f�fuc'� <br /> �f��.L ���'c(' / <br /> �-<<r.r �)1� r�,1"v��� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet A/C–air handling units <br /> _ Balhtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> Shower Walar healer <br /> _ Kilchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> __ Clothes washer Clothes dryer <br /> __ Waler heater Range hoor' <br /> _ Sink(service/bar/mop/elc.} Exhausl(ar <br /> __ Backtlow preventer Heat pump <br /> Urinal Unit heater <br /> Drinkinc� Fountain Boiler <br /> _ Floor drain _ Refrigeration <br /> Grease trap Woodstove <br /> � Roof drains Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriti(y that I have read and examined Ihis applicalion and know the same to be true and correcL All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or nol The granGng of a permit does not presume <br /> to give aulhority to violale or cancel the provision o(any olher state or local law regulating construclion or the performance of <br /> conslruction.Thal I am aulhorized by lhe owner of lhis property to perform the work for which application is made and I comply wil'n the <br /> Slale Contractors Law 18.27 RCW and 296200 WAC. <br /> �, :�1�Cnl i� �'-l"�l� a''� �� �� b <br /> Signature o(Ow er/Coniraclor/AuthOr ed Agenl Date <br /> -- ---- --- ------� <br />