Laserfiche WebLink
PERM17 APRLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEnAR STREET, EVERETT, WA 98201 <br />425-257-6810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />�, SITE ADDRESS //�n� n ^, n"l /J�TM^� <br />, 7�: J.�j Gvr�( // ��M7 <br />� LEGAL LOT NO. BLOCK TRACT <br />DESC <br />I ��FA�lb�i�nii� �3�3�o,V/�I%1m <br />i'ARCE_ TAX I.D. # <br />hill' # <br />70/-024 <br />� <br />CI IZIP PHONE ' <br />gi62� �t/�i%�'/�f�ls'� o�� � ' <br />TENANT NAME W TACT FOR PERMIT PHONE �l/� �b/ I <br />GI!/-r <br />', n'I�IST�Gbig r6/Ti� A�(lis 7z8� <br />]}j,p�CONTRACTOR ADDRESS <br />nv . !(l� JJJ 1 <br />�� CONTR.LICENSE# � l:�����/ ��=-���(��� ����I�)' <br />USE OF BUILDI/NG HEAT SOI�RCE <br />, ����L _ Eledric �[, Gas _ Other <br />�I WORK DESCR7PTION,��cq;,o,� ��y��r� yqiR � <br />' (�i/iyi�/ �E /�IA� 7D �C�� Z7�0 <br />PLUMBING <br />I <br />� NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry ;!ay <br />Sink (serwce�badmop/etc. ) <br />Back(low preventer <br />Urinal <br />Drinking Fountain `� <br />Floordrain �'�� <br />Grease trap <br />Roof drains <br />Other _ , <br />CITYIZIP PHONE <br />CONTRACT PRICE OF 4VORK �� <br />� //% 2�� I <br />MECHANICAL <br />NO. I NPE OF FIXT'.'RE OR ITEM <br />� <br />AIC — air handling units K/(/ <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas f replace <br />2s range <br />C ihes dryer <br />Ran hood p <br />Exhau fan �/�./ /t�%�% <br />Heatpu <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodsrove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />i, I hereby cer;ify that I have read and e�,amined this applica�ion and knew the same to be true and correcL All provisions of laws and <br />I ordinace� go�ierning ihis type of work will be compiied wilh whelher specified herein or not. The granling of a permit does not presume <br />' to g�ve authoriry to vio!ate or c�ncel ihe provision of any olher state or local law regulating constmclion or the performance of <br />� construction. That I am authorized by the owner of this property to perfortn the work for which application is made and I comply with the <br />' State Contractore Law 1827 RCW and 296200 \NAC. <br />l�'�,/d �n�,n �- /� 07 <br />�a <br />