Laserfiche WebLink
PERN►a APPLICATION <br />CITY OF EVE,REcTT 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 1 / <br />SITE ADDRESS �w <br />PARCEL TAX I.D. M <br />PERMIT M <br />Lit 76, <br />LEGA LOTNO. <br />DES". <br />BLOCK <br />Il7L� ll,'plJ <br />TRACTOR SUBDIVI5I011410 <br />_ <br />OWIIER ADDRESS Z PHONE y <br />Ni "\, i\ t av�c� l�9own -1UO'k Piz\vr" (( N. J;Ue(Z.iL_q- Lll (i4aoi <br />TENANTNAME <br />FOR PERMIT PHONE •j, � c-b0JQ- <br />•-) <br />(�CONTACT <br />EMAIL <br />IF PHONE -340.5(0 3 <br />Li Jr-��t+x+x:. Ste. <br />CON?R. LICENSE( jfJCJ\C3E��S�.�— <br />USE OF BUILDING KZAT SOURCE <br />COPTTRACT PRICE OF WORK <br />Clechic —Gas _ Other <br />WORKDESCRIPTION tr;i,,.�; (A `)uy^h <br />PLUMBING ME:.nANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C - air handling units <br />_ <br />Itathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />;Ihower <br />Water hoster <br />_ <br />_ <br />!'lichen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />__ <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />= <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />De;, ping Fountain <br />Boiler <br />Floordrain <br />Refrigeration <br />Grease i*ln <br />Woodstovo <br />P.00ldrains <br />._ <br />Cl.-ar_ -_ <br />I <br />Other <br />CITY OF EVERETT LCCAL SALES TAX CODE IS 7105 <br />hereby comity that I have real and examined this application and know the sarno to be true and correct All Drovisions of laws and <br />ordinates governing this typu of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authorhy to violate or cancel the provision of any other stale or local law regulating construction or the performaoce of <br />construction. That I am autLor.zed by the owner of this properly to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 ACW and 296.200 WA-, <br />Signature of rc;�ontractor/Authon' ent Date <br />P'J <br />