Laserfiche WebLink
SITE ADDRESS <br />�j 0 <br />LE LOTNO. <br />UESC. <br />OWNER �� <br />TENANT NAME 1 <br />CONTRACTOR <br />CONTR. <br />PL.ZMIT APPLICATIO��. <br />CITY OF EVERETT' PERMIT SERVICES <br />3200 CEDAR STREEf, EVERETT, WA 88201 <br />425-257-8810 — FAX 425-257-8857 — www.everetlwa.org <br />APPLICATION5 ARE ACCEPTED FROM 8 AM TQ 4 PM <br />3 Q,ef t1(1a71fe <br />, � BLOCK <br />TRACT <br />PARCEL TAX I.D. M <br />�itlE J/o2 <br />ICONTACT fOR PERMIT <br />�/�tt'�P�La. �/Q/�heJ <br />PHONE <br />-755�__L�'f` <br />[ , /�m „ Tw ' DDRE85 � CITY2IP ' / Pr N�� <br />.[3�•{� O/Kx 'Ld <br />; �»����� 9si� S��.C/�/oz, �t,E�'�i� <br />USE OF BUILDING <br />WORK D SC` � RIPTION � <br />C�<JGe� 2 U � <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />BelhWb <br />Levatory (wesh basin) <br />Shower <br />Kitchen sink 8 dispusal <br />Dishwesher <br />clotnes wasfier <br />Laundry iray <br />Sink (servicePoarlmopletc.) <br />BeckOow prevenler <br />Urinel <br />Drinking Fountain <br />Floor drein <br />Greese trep <br />Roof dralns <br />Other <br />- HEAT SOURCE I CONTRACT PRICE OF WORK <br />Eledric ✓ Ges _ Other <br />l�/� �. � � <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air hendling unils <br />�Forced elr eyatems <br />Ges piping <br />Watar heater <br />1 Gas fireplece <br />L Gesrenge <br />J_ Clothes dryer <br />,�L Renge hood <br />Exheustlen <br />_ _ Heel pump <br />Unit heater <br />'� Boiler <br />� � Rehigeration <br />Woodstove � <br />Other <br />CITY OF EVERETT LOCAL 8ALE8 TIVI CO�E IS J706 <br />I hereby ceritify that I heve read and ezamined this epplicetion end know Ihe seme to be true end wnecl. All proWaions ol lews and <br />ordineces governing this type of work will bo complietl with whelher spedfied herein or not. The grenling o1 e pertnfl doas not presume <br />to give euthority to violate or cancel the provision ol eny other slete or local !aw reguleUng construclian or the perlortnence of <br />construction. That I am euthorized by the owner ol lhis praperty to perfortn lhe work for wFdch epplication Is mede end I comply wlth V�e <br />Sta�e Contrecrors Lew 18.27 RCW end 296.200 WAC. <br />