Laserfiche WebLink
r P�.ZMIT APPLICATIO�� <br />li � CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, E`JERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org �� � j , -�, / _ l' / <br />APPLiCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS AR NOT ACC PTED <br />SITE AD�RESS 1 � PARCEL TAX I.D. # �-�RMIT # <br />'�,I�' �����-- �. „_,..�i,� oOS� 7 0000 �� ��'�C�''J�- �l <br />LEGA� LOT N0. BLOCK TRACT �� �� <br />uesc. ; i t�e,�1e.rL�, �-anP� 9�' I�� z-�'1- oy <br />�� f �'�n,» i-io�'�'i S InG )DI�1 �;verare�n(��u F,�rrr°�if US.�Oy y7b'• <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />CONTRACTOR AODRE55 LITY/ZIP PHONE <br />/�rEi50.r1 ��Otr�ES L,e. ioia i�'ue��ree�� l�� �u��xe��tf QS�o�/ �C(� � il7S'• 4�9y7 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />� � ��rJC.t�`� f �ar��i��; <br />WORK DESCRIPiION �' j,� ,�.!�, �. )� � <br />PLUMBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />? TLilet <br />dathtub <br />� Lavatory (wash basin) <br />� Shower <br />/ Kitchen sink & disposal <br />—! Dishwasher <br />T Clothes washer <br />l.aundry tray <br />Sink (service/bar,�mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinkin9 FounWin <br />Flocr drain <br />Grease trap <br />Roof drains <br />Cther _ <br />HEA7SOURCE <br />_ ElecMc � Gas _ Jther <br />. c. t1 1-', <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTIIRE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Nlater heater <br />Gasfireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Bailer <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />I hereby ceritify that I have read and examined this applicatlon and know the same to be t��e and correct. All provisions of laws and <br />crmnaces governing this C,•pe of work will be complied with whether specifed herein or not The granting of a permil does not presume <br />to give authority to violate or cancel tne provision of any other state or local law regul2ting constructlon or the performance of <br />consruction. That ! am authorized by the owner of this property to perform the work (or which application is made and I comply wilh the <br />State Contractors Law 18.27 RCW and 296200 WAC. <br />S�gnature of OwneuContractonAuthonzed Agent Date <br />