Laserfiche WebLink
SITE ADDRESS/'' / �j <br />�J �U "S C. t=:^'iY�cT7 <br />LEGAL LOTNO. <br />DESC. <br />PERMIT APPLICATIt�N <br />CITY OF EVERETT PERMIT S�='RVICES <br />3200 CEDAR STREET, EVERETT, W'198201 <br />425-257-8810 - FAX 425-257-8857 - www.�averettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Z—/ � <br />5 �;. <br />BLOCK <br />�' PARCELTAXI.D.# PERMIT# <br />fi-1 //o� - D�� <br />TRACT <br />C't7 Si\ti,,, 3on 1`�) J-�-�%, L�r.� v. 7 3<� .'S�c:���k � u,�(} �� 1Q )`�7,�.�3 1 <br />TENANT NAhiE CONTACT FOR PERMI'� PHONE <br />���,�,�s�),�,� ��>„� l��,��<� �r��,�}71-a��7 <br />CONTRACTORI ,' /� A�DJRE55 1 ^ ^• CITY2'IP•,� <br />G"fiS T��wt�dc�Y.)I•.�J �t7J C�YYI/�.t.�`,�,� ��t1nYb"C�"'hY <br />CONTR. LICENSE # . _ � _ _ , <br />USE OF BUILDING <br />R��.1 <br />WORK DE$CRIPTION <br />��ii� I I ) r�.,s�, � <br />� -Flw-�,-,�.�}- <br />HEATSOURCE <br />_Eleclric �Gas_Other <br />PHONE <br />2�:�,�a <br />.3� �7 � L� 7 <br />CONTRACT PRICE OF WORK <br />7 �� " <br />, <br />� aS �, {,� �� �.,�/, ��5� �y K,�,�r- �.-,�4-;� �,� n�ps <br />NO. � TYPE Of FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Orinking Founlain <br />Floor drain <br />Grease lrep <br />Roof drelns <br />Other __ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Clethes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigerali�n <br />Woadslove <br />Other <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerifify that i have resd and examined this appliCation and knoW lhe S2me t0 bE tNe 811d CO�fACi. All pIOVISIQIIS Of �2WS 211d <br />ordinaces governing this type of work will be complied with whalher specified h�rein or neL The grenting ot a permit does not presume <br />to give aulhoriry to violate or cancel lhe provision of any other state or local law regulaling construclion or lhe perbrmance of <br />construction. That I am authorized by the owner of this property to perform the v+ork for which application is made and I comply wiih the <br />State Conlractors Lew 1�� �27 RCW and 296.200 WAC. <br />(� _ _,,, ?'G� .T�. �' �, y ^ 1) <br />