Laserfiche WebLink
P�RMIT APPLI�i4Tl�,N <br />CITY OF �VERETT PEG2MIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8&57 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />LOTNO. � BLO�K � TRACT <br />DESC. <br />PARCEL TAX I.D. # <br />I;A/,c,��'T? i.�✓� `/`i LCi6 <br />/���i)Ji-5�,� i'Vlri/?(�yii�IT2 ��z'1 i�2.c- 1`-IUZ Sh? �viGiLETT I�✓1�1.�W�9q <br />TENANTNAME � CONTACTFORPERMIf PHONE <br />✓�/�s i< �,� �2o�Q..Si.. , s �!J✓hJ (.v,ti � u r 2 v r-. � c� $- z 3 2 z _ <br />CONTRACTOR ���ti/�}�JT yMi�Gl��<ir16�'�jDDRESS CITY2IP PHONE <br />, i �,ps �-�E�v <br />CONTR. ICENSE # � � �� 2U6'- j V y� 3 j 2 j <br />Sl ccdcrL`�9F � �"]/3 /�'7�}v:� rv2 SivLv�'unisi� w/� 7� 2l0 <br />USE OF BUIL�ING � HEAT SOURCE � CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />'�l-�,%ias,%� j�z.rlPi: p�/1�,�7iZ�vr� <br />NO. � TYpE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Cbthes washer <br />Laundry tray <br />Sink (service/bar/mop/eta) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />Glectric Gas Other <br />NO. I TYPE OF FIXTUR6 OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas pipinc� <br />W atc r heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausl (an <br />Heal pump <br />Unit heater <br />Boiler <br />Re(rigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7'AX COOE IS 3 i05 <br />I hereby ceritify that I have read and examined lhis application and know the same to be true and correcL All provisions of laws and <br />ordinaces goveming ihis rype of work will be complied wilh whether specified herein or noL The grenting of a permit dues not presume <br />to give authority lo violale or cancel the provision of any olher state or local law reguiating construction or the periormance of <br />construction. That I am aulhorized by the owner o( lhis properly lo perform t'ne work for which applicaliun is made and I comply with lhe <br />Slate Contractors Law 18.27 RCW and 29620C WAC. <br />i _ �/ /.. �� J._ S�6�n � <br />�Z) <br />