Laserfiche WebLink
SI'fE ADDRESS <br />LOT NO. <br />. <br />� <br />PERMIT APPLICATION <br />CITY OF 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 />j C0 � pqRCEL TAX I.D. # <br />BLOCK � TRACT <br />� -� <br />TENANTNAME CONTACTFORPERMIT PHONE <br />zun,��cz. <br />I 17t-'�rvlS �i�NS�Y 425-l�OZ-43�S <br />CONTRACTORM,�ycT MQHAN�LAL��1-r1C� ADDRESS�j��j,p_�S,�j20A�'g���TY�ZIP PHONE �L{2S� <br />�nuN� �{Q�� �2"L�i. <br />CONTRLICENSEC (�1�CQ�'['(�,�I�_IO�JCNL <br />USE OF BUILDING <br />� <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />qSOs2 <br />CONTRACT PRICE OF WORK <br />$ 5L`U . vo <br />WORK DESCRIPTION <br />L,OfJNLCi ID �X�� � ING, �AN�TK1tZ�l A�vD W'ATC-� , AL� �120V i L� <br />YGi2 �l.l'tLUP.E. lASC-HC-,�. <br />NO. I TYPEOFFIXTUREORITEM <br />Toilet <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />� Clothes washer <br />Laundry lray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roofdrai�„ i <br />Other �15� - � Z <br />— '/4,,,�'�rZ. L11.1E-�i�o, <br />NO. <br />m <br />TYPE OF FIXTIJRE OR ITEM <br />AIC - air handling uni;s <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas firep�ace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Other _ <br />CIN OF EVERETT LOCAL SALES TAX COD'e IS 3105 <br />I hereby centify that I have read and examined this application and know lhe same M be lrue and cortect. F'? provisions ot laws and <br />ordinaces governing lhis type of work will be complied with whether specified herein nr not. The granting of a permit does not presume <br />to give authority to violate or cancei the provision of any other state or local law regulating construction or the perfortnance of <br />wnslruction. That I am authorizeo by the owner of lhis property to perform the vmrk for which appliwtion is made and I wmply wilh the <br />State� Conlractors Law 18.27 RCW and 296.200 WAC. <br />ll ;7 ✓� � �Irl <br />