Laserfiche WebLink
SITE ADDRESS <br />� �l I <br />LEGA LOTNO. <br />� <br />PERMIT AFPLICATION <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 <br />� �a�BLOCK TftACT <br />PARCEL TAX I.D.11 <br />i� si <br />/� P RMIT # <br />��1.� _�_�, <br />�-/4�D <br />98asg <br />7ENANTNAME e <br />CONTACTFORPERMIT PHONE <br />�ere,� �'i�cl�l�ef�Pv� 36oY�57-c?lf�� <br />CONTRACTOR I 7 �� QC-I�UNI(Q' � ADDRE99 ��� CRYILP PHONE 7�p0-6S 7vl/8c% <br />�n �im� <br />CONTR. UCENSE � uN w� nnIOA 3M �, �L/ �X l Ll� � ���u v�s � l l� w� 9Ba� o <br />USE OF BUILDING <br />�'< S i c�e r ii q� <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />p o r. <br />Eledric Gas _ Other �� O � <br />WORKDESCRIPTION �,.�k.�ar s 6{¢.0�--� <br />�,.�iu �i a kor � a,,in.,,,�, t,�� ��;. < sp. y <br />N,�, I TYPE OF FI7(TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen si�� 8 disposal <br />D�shW tr <br />Clo�, �es washer <br />laundry tray <br />Sink (serviceNarlmopletc.) <br />BadcBow preventer <br />Urinal <br />Onnkmg Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ <br />NO. I TYPE OF FIXNRE OR ITEM <br />AIC - air handlirg units <br />Forced air syslems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />He:,t {wmp <br />Unil heater <br />Boiler <br />Rehigeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAI( CODE IS J705 <br />I hereby centify that I have read and exemined this application and know the same to be We and cortecl. All provisions of laws and <br />ordmaces goveming this rype of work will be mmplied vnth whether spedfied herein a naL The granting o( a pertnit dces rat prewme <br />to give authority to violate or cancel the provision of any olher state or local law rcydlating consWQion a the peAormance ot <br />construction That I am authonzed by Ihe owner of this propeAy to peAortn the work for which appliwtlon is made and I comply with Ihe <br />State Contractors Law 1827 RCW and 296200 WAC. <br />�%�, /�i /� �./l '/�✓` ( t/ <br />�na'WFe o� erl ontractod . nzed Agent � Z <br />