Laserfiche WebLink
ADDRESS <br />LOT NO. <br />DESC. <br />PERMIT APPLICATION <br />CITY O� 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 />BLOCK <br />PARCEL TAX I.D. # <br />TRACT OR SUBUIVISION # <br />TENANTNAME � ACTFORPERMIT PHONE u2S'ToI'7�0 <br />� i, 1.!/�r�Y\� ���1\T� V�P`�L I(/C ��( i� l.l�Jl/i.s� E.MAIL IPS'J) �i.�.11_( J�I.�Y <br />�re I,rotQci-ion <br />USE OF <br />WORK DESCRIPTION <br />� (.D vIPAC� <br />�2.\oCa�- C-�� h2c►G� <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Ba�htub <br />Lavalory (wash basin) <br />Shower <br />ktchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />(�j D�x �2�13 <br />t�'I J re�K "�91 <br />HEAT OURCE <br />_ Electric _ Gas _ Other <br />UZS•ys/• �(0(09 <br />CONTRACT PRICE OF WORK <br />��� cx� <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler h�ater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES Tti( COUE IS 3105 � <br />I hereby ceritify that I have read and examined Ihis application and know ihe same lo be irue and correct. All provision; ol laws and <br />ordinaces governing lhis type of work will be complied wilh whe!her specified herein or not. The granting of a pertnil does nol presume <br />to give authority to violate or cancel the provision of any olher state or local law regulating construclion or ihe perlortnance o( <br />construclion. That I am authorized by the owner of this property to perform the work for which application is made and I wmply wilh the <br />State.�%r lractors Law 1827 5�W( and 296.200 WAC. <br />