Laserfiche WebLink
SITE <br />i <br />P�RMIT APPLICATION <br />CITY OF EVERETT PE�MIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROA7 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />r 3 �z�Q ,.�-� ---- I <br />LOT NO. BLOCK TRACT OR SUBDIVISION # <br />TENANTNAME CONTACTFORPERMIT <br />C� �-, b� P �r',� (�a � <br />NTRACTOR ;2 /' � I',��v� (,.t AODRESS /5� �jL ;-�1� �� CIl <br />,c � �g y� <br />CONTR. LICENSE # �'r S F�� ( S �Z j NE �- S- I U <br />USE OF BUILDING <br />� 7n^^ �- <br />WOFiK DESCRIPTION <br />�-R �'�'� <br />\ <br />NO. � TYFE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dish�vasher <br />Clolhes washer <br />Water heater <br />Sinh (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floordrain <br />Grease lrap <br />Roof drains <br />Olher <br />HEATSOURCE <br />_ Electric _ Gas _ Olher <br />�D -.�y-o?� <br />PERMIT # <br />1CJ�/0-GCoC� <br />PHONE <br />y-�c <br />9d'/UG <br />CONTRACT PRICE OF WORK <br />� d� i� J7� <br />N0. I TYPE OF FIXTURE OR ITEM <br />� <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhausl fan <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX COCE IS 3105 <br />I hereby ceritify that I have read and examined lhis application and know the same to bz lrue and wrrect. All provisions o( laws and <br />ordinaces goveming ihis type o( work will be complied wilh whelher specified herein or nol. The granling of a permil does not presume <br />lo giva aulhoriry to violale or cancel the provision of any other stale or local law regulating construction or the performance of <br />conslruction. That I am authorized by lhe owner of this property lo perform 1he work for which application is made and I comply wilh the <br />Slate Conlreclors Law 1827 RCW and 296.200 WAC. <br />Signalure of OwnedContrectodAuthorized Agent Gate / <br />I �/1 i <br />yZ <br />