Laserfiche WebLink
12/06l2U�6 15:14 8�19720154 SOURCE REFP.IGERATIOP7 FAGE 02/10 <br />SITE ADDRESS <br />LOT NO. <br />PEaM{7 APPLICAiIUIV, <br />CITY OF EVER�TT PEFtM{i SERVICES <br />3200 CEDAR STREET, EVERETT, V�JA 98201 <br />A25-257-8810 — �AX 425-257-8857 -• www.evem_thva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />9LOCY I TRACT <br />PARCEL TAX I.Q. # <br />f`�i �LI-Fa�� 1 s __ '—v+�nnc as 5e,c.;'� <br />TENAN7 NAMG I CONTACT FOR PERh71T <br />M�C-Fd A,C 1S _ �M P.�' {�I i��a <br />CONTRACTOR �Kn�c���G�noN�Nf�F7L ODpES9.3afb2UJ• i�/4J/�� <br />SFn-rr� , r✓A <br />CONTR.LICENSE# �URGSZ�R�1�j P� y�aO2 <br />USE OF BUILDING <br />WORK DESCI?IPTION <br />NO. I TYFE OF FIX�I'l1RE OR ITEM <br />Tollel <br />B�thtub <br />Lavalory (wash bnsin) <br />5hower <br />I(ilchcn sink & dispo6al <br />Dishwasher <br />Clolnes washer <br />Laundry lray <br />Sink (servlcelbar/mop/etc.) <br />Bockflow pmvcntc� <br />Unnnl <br />Drinking Founlaln <br />Fl�or drnin <br />Grease Irap <br />Roof dralns <br />Olher__ <br />HEAT SOl1RC� <br />_,_, ElccMc ,L/ Gas _ Olhef <br />GITY/ZIP PIiONE <br />PHONE <br />�7�s3� &33-�3av <br />C04TRACT PRICE OF WORK <br />S(o� J`i�S� �v <br />NO. I T'PE OF FIXTURE OR ITEh1 <br />PJC – oir handling units <br />Forcetl air syslems <br />G2s piping <br />Woter henter <br />Gas firepince <br />Ges rnnge <br />Clolhes dryet <br />R�ngehood <br />F�chaustfan . <br />Heot pump <br />Unit healer - <br />8oiler <br />Refrigcrotia7 <br />Wootlslove <br />Olhcr <br />CIN OF �VERET7 LG,^•AL SALES TAX COOG i9 1�05 <br />I here6y cerility that I have rcad and examined this applicouon and know the seme to be true and wrrcct. nli provisions of lav:s and <br />orJinaces govcrninq fhi� I uf emrk ��rill be complied with whelher spcGfied herein or not. The granUng af a pertnit does not presume <br />�Io horiry to violote or nccl the provlslon o( any other state or local law requleting conelrucllon or Ihc pertormance of <br />nslruCLo ?hnl I am ui fhcf >ed by iho ownef ol ;hls propedy lo pertorm the work for eriilGi applica6on is mPde and 1 compiy wlth the <br />e ConUa tors Lovi�18 �7 "W and 29d2�0 WAC. � � <br />\I <br />�. MAA/i. RA/ /1 �. i��/l(.. <br />