Laserfiche WebLink
SITE ADDRESS <br />z,O�Z �vl,I <br />� EGA LOT NO. <br />oesc. 'i <br />dERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />J200 CEDAR STREEI, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. N <br />D2�vF ZY>USI�I�O70- <br />BLOCK J_ TRACT OR SUBDIVISION M <br />A <br />_ (� <br />�ROstr 1 wC�JJ'�I1I �Q�Z � �av � C rI CNI WM •IU$•�'l�L <br />TENANTNAME <br />CONTACT FOR PERMIT PHONE yt s. � 0 N•��ol <br />��n-.cick M�c�`1^^� E•MAIL <br />cvn i nn� i.+n <br />C.�f -L r.oct'c�. wCi � 2d� � R�c�cl,.-d n..� <br />CONTR.LICEN9LN S�•k ( �7 <br />USE OF BUILDING <br />�J�- - ho� .-.-.1... <br />.�.�k,._,4 <br />HEAT SOURCE <br />_ Electric �, Gea _ Other <br />J3S•`�9?2 <br />S..e�..o�+��� �LZSJ <br />CONTRACT PRICE oF wunn <br />� 35, o00 --- <br />WORKDESC1RIPTIIO!N1 ` b�/ Ra°M �.�f w'ko � Roo� <br />A�I/� /�['(ll`�l� � O'� N'JJC �J�' � <br />PLUMBING <br />N0. I TYP �F FIXTURE OR ITEM <br />Toitet <br />Balhtub <br />Levetory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Weter heater <br />Sink (servicelbar/mop/etc.) <br />Beckllow preventer <br />Urinal <br />Orinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />N6. I TVPE OF FIXTURE OR ITEM <br />A/C — air hnndling units <br />Forced eit systems <br />Gas piping <br />Water heeler <br />i�i83 �fOj.�3C0 <br />Gns range <br />Clothes dryer <br />Range hood <br />1_ Exhaustfan <br />Heal pump <br />Unil tiealer <br />Boiler <br />Re(dgeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7106 <br />I hereby caAify that I have read and examined this application and know lhe seme to be Irue end cemect. All provisions ol lews end <br />t give autho ily IoI Idt t�e or cancel 11 e prov sion oileny ol'heWstat eor local lawh egulat ng constructionior�ihe performence ot 1 Presume <br />constructlon. That I am aulhorized by Ihe owner of this properly to peAorm tha work for which eppllcalion �s R�ade and I compty wilh ihe <br />Slate Contractors Lew 18.27 RCW and 29�.200 WAC. <br />!�(`2%�� __�a-Z3- /O <br />vnedCoNraclodAuthorized Agent Date �/� <br />