Laserfiche WebLink
PERMIT APPLICATION <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ---� -�c� <br />SITE ADDRESS PARCEL TAX I.D. # P RMIT # <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. C ... , <br />K <br />`A <br />OWNER DRESS CIT /ZIP PHONE <br />Z <br />S � �. � �.�3 . <br />I�'I(� • s�e�cY15 t-�2.5-�e.,�el�.s <br />�Yy1e5 <br />= C1C.�_k t�1�r1 #ZOC� 9 �Zs 0 �S <br />TE'NAT "ME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR S ApDRESS CITY/ZIP PHONE <br />CONZiiLIC� #�" `}.:s�i,=wi <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Z <br />—Electric _XGas —Other <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />—L <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />_j_ <br />Water heater <br />Kitchen sink & disposal <br />_� <br />Gas fireplace <br />Dishwasher <br />I <br />Gas range <br />I <br />Clothes washer <br />_� <br />Clothes dryer <br />Laundry tray <br />_I_ <br />Range hood <br />Sink (service/bar/mop/etc.) <br />_(� <br />Exhaust fan <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />1 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 />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 Con ctors Law 18. R7 and 29 .200 WAC. <br />SkgmafCrf�- <br />e 5f Ow r/ ntr-act r/Authorized Agent Dfate <br />