Laserfiche WebLink
SITE <br />P�r2MIT APPLICATIG�� <br />CITY rJF EVERETT PERMIT ;iERVICES <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />LOT N0. <br />TENANTNAME <br />BLOCK <br />t6TY�c cil� <br />CONTR. LICENSE # <br />uNi�v ��y7 N-T <br />USE OF BUILDING <br />GaS/Nd <br />WORK DESCRIPTION <br />To �/�stcu � �� (oltii/�7erGr <br />PARCEL TAX I.D. # <br />rfb � �[�l'i — <br />TRACT <br />CONTACT FOR PERMIT <br />T�� n,a s L <br />ADDRESS <br />� <br />PHONE <br />���-�%� �� � <br />�..'? PHONE <br />�.?��,�- G,�'hiytda�� <br />n � 7 <br />HEAT SOURCE � CONTRACT PRICE OF WORK <br />Electric �Gas _ Olher /���� <br />SJ'/� �C'X -c��.s`N �t-L , ��1�p <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bat�'ub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 dispusal <br />Dishwasher <br />Clothes washer <br />Laur.dry tray <br />Sink (service/bar/mop/etc.) <br />8ackflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Vap <br />_ Roof drains <br />Other <br />(<< fiGj �°�t }1�-yzP ( ¢��� <br />����P��- rz�t �.� <br />NO. I 7YPE 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 range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woodstove L � <br />Other �I.1 C�t Cr �l P6c f l� (/� <br />CITY OF EVEREiT LOCAL SALES SAX COQE IS 3'105 <br />I hereby ceritify tha: I have read and examined this applicatlon and know the same to be lrue and correct. All provi,ions of Iaws and <br />ordir�aces governing this type of work u-ill be complied with whether specified herein or not. The granling of a permit does not presume <br />to give authority to violate or cancel the provision of any uther state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this prop: rty to perform thz work for whic application is made and I comply with the <br />�late Contractors Law �8.27 RCW and 296.200 WAC. <br />, �o—���c <br />���� � <br />Signature of OwnedContr tor/Authonzed Agent Date �L <br />