Laserfiche WebLink
PEkMIT APPLICATIOIv <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 />SITE ADDRE55 <br />� 2"i 1 (��n.i0�l v-'�N Lq�v�- <br />LEGAL LOT NO. BLOCK <br />DESC. 1 f � <br />1 � �`=' '�Tr��T�: ' Pa��x� •s �Lc• <br />TENANT NAh!E <br />CONTRACTOR <br />CONTR. LICENSE # <br />USE OF BUILDING <br />o —1 S�-d_� <br />PARCEL TAX I.D. # i �R�T # <br />��osl'to02l3�00 � � <br />O 5 1 1 cX�'t 1'��n �� �" <br />TRACT <br />AD�RESS CITY2IP PHON� � <br />t2�q9 �/i�:WC�c� Mvk.� ��O W�• <br />� �.�rt,s� PL.}k�n2 �tv��-t� <br />CONTACT FOR PERMIT PHONE <br />�.s,� : ±-4a,G-��=R <47�� ; 3`�; <br />� 1-.ADDRESS C1Ti21P PHONE <br />�'i"5���'� �,�YiSC� D��/bc�. D�J3-7 /G./ <br />. �.�� S- •. / / (.r tY.1 L`,g ' . . , .. , . • • <br />. . �,n .. , . . . . �/ c' � 7 / <br />�Z.�`S \ O�� \"l A..L. S. F <br />l'1 • - <br />� <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />.:. <br />CONTRACT PRICE OF WORK <br />Z '�`� �7!X� <br />WORK7ESCRIPTION N�(�f �UF�:I7A��OIJ U�ibE�L RW�I�I� �`}OUSLG <br />�,�..����: c���� i <br />�����` _. ,� 11iiW 14' x 2Z� GPR���c <br />NO. + TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhlub <br />Lava' .ry (�ti�ash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handlinc� uniia <br />Forc�d air syslems <br />Gas pipinc� <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranc�e hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES T!il( CODE IS 3105 <br />I hereby cerilify lhat I have read and examined this applicalion and know lhe same lo be lrue and correcL All provisions of laws and <br />ordinaces goveminc� ihis type of work will be complied with whether specified herein or not. The granting u( a permit does not presume <br />lo give authnrity to violate or cancel lhe provision of any other slate or local law rec�ulaling construclion or the performance of <br />construction. hat 1 am aulhorized by the owner of Ihis property lo pedorm the work for which application is made and 1 comply wilh the <br />Stale Contra �ts La�v 18.k7 RCW and 296.200 WAC. <br />�I��-11��5 <br />'lz <br />