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 />t APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />r <br />SITE ADDRESS ' G <br />S/ <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DISC. <br />OWNER E- DA �-J� // //1YvESfii�'iiC-"w> ADDRESS CITY/ZIP PHONE <br />/V%u /j v 4-).4 <br />TENANT NAME <br />ON CT FOR PERMIT PHONE <br />fcJf%Ann f5-- <br />off�h <br />CONTRACTOR — RP R //f /IV v€sf i ✓v/ADDRESS " 5 CITY/ZIP PHONE <br />� <br />CONTR. LICENSE # _ <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICEOF WORK <br />`S &L Z- ,,AhA//x <br />_Electric Gas _Other <br />0 <br />WORK DESCRIPTION <br />/ Z1 L/ 2Z�� <br />PLUMBING <br />MECHA141CAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />oL <br />Bathtub <br />f <br />Forced air.systems <br />2 <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />/ <br />Gas fireplace - <br />Dishwasher <br />Gas range <br />Clothes washer_ <br />Clothes dryer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Range hood° <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 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 />ordinates 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 Co actors L w 18 2727 R nd 96.200 WAC. <br />Sig ature of Owner/Contractor/Authorized Agent Date <br />