Laserfiche WebLink
PC �MIT APPLI�ATIG� . <br />CITY O� EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org 3_aS—/(7 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8� CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # <br />"�OiF `� Evz�'e��'vlall `Vy S1L`I`�� IQJL� �7 0�{ po az <br />LEGAL LOTNO. BLOCK TRACT � <br />DESC. <br />DWNER ADDRE55 CITY2IP <br />'�I.u��E2 �v�rctl" f�(u�li�yS���C lQnl vlv��ohS%• d��C'D Stq�c�WR <br />TENANTNAME � <br />�uSC� nHoIV�1 f <br />CONTRACT �j � <br />\ f" <br />CONTR. LICENSE # <br />USE OF BUILDING <br />��-k�e CP�) <br />CONTACTFORPERMIT <br />�tN �1 <br />HEATSOURCE <br />Electric Gas Olher <br />ciTv2ia <br /># <br />PHONE <br />�' ' / <br />- iD� - �y�'L k1U 6 <br />PHONE <br />CONTRACT PRICE OF WORK <br />���D� �D� <br />WORKDESCRIPTION 'r�.�mhi- �vy�pVUv��V�CV�-I' � f cll� ek(�11�1c�c,�i(2 SI��C�• Rf� �Xie��Gr w01"IL. <br />i.',+C�9U1' YCI9�VcL"IZGj15 ���CIUaQ �14^u�iS�'l�ll�G� C:k15f"li'!g-1 n��i�l- w�,�I�,ty1�71I11'1C� C%'f5j7!'+� II <br />,.lcJ� '� ;'ri'lIfCS r(�IVNr�Iv�:tM��1 D�Fi�L � aY'�f1'k�h.�iDvld� Y`2W �WOi'1C.� J <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash f�asin) <br />Shower <br />Kitchen sink & disposai <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. i TYPE 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 />P.ange hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br />I hereby cerilify that I have read and examined lhis applicalion and know the same lo be lrue and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied wilh whether specified herein or not. The granting of a permit does not presume <br />to give authority to violale or cancel lhe provision of any other stale or local law regulating construclion or the performance of <br />construclion. That I am authorized by the owner of lhis pmperty to perform the wcrk forwhich application is made and I comply with the <br />St(at/e Contraclors Law 18.27 RCW and 296.200 WAC. <br />7�� ll'i'nni �-Ii-ID <br />Signalura�of Owner Contractor/Authorized Agent ` Date <br />yZ <br />