Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SEkVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />� <br />APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM ,� � ;�-' L_ <br />SI7EADL"iESS�O�� �� <br />LOT NO. , � I BLOCK I TMCT <br />PARCEL TAX I.D. M <br />Y�i <br />ONMER ADDRE8S CITY2IP PHONE <br />�3elrrlor►+e Hc,�g�tts u� qs�� �-mstrv��roz ��,����,cg (�u�a�i��o <br />TENANTNAME CONTACTFORPERMIT PHONE <br />�rG1fi Dc LA-Ue�LJn� (y2S)7Si-�SBg <br />CONTRACTOR /I,e/,,,,� ___/y �y,��s AODRE85 -r7 CITY2IP PHONE I ��7 <br />IJG//WYl.rv % '/ �/J�(�J �/ Tr � ���y (//�" (�LS/�'I�7/� <br />CONTR. UCENSE t/3�ur� aN � 9 y�t� o ��7 �"" J`"'f lil (�/"u�-�f "" 'j�0]�� <br />�o w <br />USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORN <br />Eledric �Ges Othe� <br />WORK DESCRIPTION <br />�jq,SIC �`� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Tollel <br />Balh�ub <br />Lavatory (wash hasin) <br />JhOWCf <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry Iray <br />Sink (senicelbeilmopletc 1 <br />BackOow prevenler <br />Unnal <br />Orinking Fountain <br />Floor dram <br />Grease Irap <br />Rooldreins . <br />Other <br />N0. I TYPE OF FIXTl1RE OR ITEM <br />AIC – air handling uni�s <br />Forced eir syslems <br />Gas piping <br />Waler heater <br />Gas fireplece <br />Gas range <br />Clothes dryer <br />Range hood <br />Exheusl lan <br />Heat pump <br />Unit heeter <br />Boilar <br />Refngeretion <br />Woodstove <br />Other <br />CITV OF EVERETT LOCAL SALES TA% CODE 18 J706 <br />I hereby cenhty ihat I heve read and ezamined ihis applicatian and know the same to be trua and covect. All provisions of lews end <br />ordinaces govemmg this type ol work will be compGed with whether specified herein or nol The granting ol a pertnit doea not preaume <br />to give authonly to violate or cancel the provlsion ol eny olher state or local lew reguleting construdion or lha peAortnance ol <br />construction. That ; am authorized by Ihe owner of this propaAy to peAorm Ihe work for which application is mede and I camply with ihe <br />State Contractors Law 1827 RCW and 296200 WAC. <br />?I �t(�l� <br />