Laserfiche WebLink
� <br />� "�,ri ( <br />� <br />SITE ADDRESS <br />i r' , <br />.___L�•� �i' L�r�i �'�i. <br />LEGAL� LOT N�— <br />DESC.' � {. <br />OWNER <br />G- ;'l, rS7� L/ S<<� <br />TENAN�NAME <br />l�Q/ �t i/�" <br />CON1'RACTOR <br />CONTR. LICENSE # ��� <br />USE OF BUILDING <br />v�i'<r <br />F�tRMIi APPLICATIUN <br />CITY OF EVERETT PCRMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 C— FAX 425•�257-8857 — www.everettwa.org <br />APPLICATIONS ARE AGC�=PTED FROM 8 AM TO 4 PM / p i`g —Q <br />: <br />WORK DESC IPTION <br />�' GL/Y/�j� �' G�-� � <br />/ <br />� <br />NO. I TYPE OF FIXTURE OR ITEId <br />/ ToilCt <br />Balhlub <br />�' Lavatory (wash ba�in) <br />'�- Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/badmop/etc.; <br />BackFlow prevenler <br />Urinal <br />Drinking Fountain <br />Floor �lrain <br />Grease trap <br />Roof drains <br />Olher <br />F'ARCEL TAX I.D. # <br />c� S �o <br />TRACT <br />111 fQ!r'�•i�%f/ �%� �G' � <br />ADDRESS C <br />�� �; , .G��:>k�/t/E �r <br />CONTACT FOR PEi;MIT <br />i L <br />�hir , r"� �in /T� <br />ADDRESS <br />�� <br />PERMIT # <br />^ Z �"�� _ <br />� <br />PHONE <br />�;� <br />riK�^ ��� CITY2IP PHON'e <br />s�a�f�{trPkA� E'co.Nca.�h.rt¢r <br />�S Lctkel�wsf �.a�c <br />�Il?�v� �(.�R 9�00�0 <br />HEATSOURCE <br />Electric � Gas _ Olher <br />PRIC� OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ran�e <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Haat pum� <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Olher__ <br />CITY C�F EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this applicalion and know fhe same lo be true and correct. All provisions o( laws and <br />ordinaces governiny this lype of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authorily to violate or cancel lhe provision oF any olher state or Iocai law regu�ating construction or lhe performance of <br />consWction. That I am aulhorized by lhe owner of this property to per(orm lhe work for which applica6on is made and 1 wmply with lhe <br />Stale Contrectors Law 18�7 R GV and�` 6.200 WAC. <br />,c�__J . �� . _\Yi <br />�/y <br />