Laserfiche WebLink
SITE ADDRESS <br />� Z2 <br />LEGAL LOT NO. <br />DESC. � G <br />%/�h <br />TENANT NAI9E <br />NERMIT AF'PLI�CATIvN <br />CITY dF EVERET"i PERMIT SERVICES <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 <br />PARCEL TAX I.D. # I PERMIT�O� �/ <br />Lo���i/�o�� < °v��oiG��d �� �� <br />vl �95'v � o <br />TRACT OR SUBDIVISION ii <br />�=%/✓S /Y7T.o �Ti//���,5� � r�c�oi�ifi ��Z �O <br />CONTACT FOR <br />PHONE G/� S G/�/� 3 <br />I� /Q'h /'iGf �G/il f E-MAIL <br />CONTI2ACTGR AODRESS CITYIZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />%�C:_?I il�,liG �� <br />WORK DESCRIPTION / <br />�f. OI�� /JU I G Gt <br />/�c �=,c � U�c ,L <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />W ater healer <br />Sink (service/bar/mop/etc.) <br />Back(low preventer <br />Urinal <br />DrinPing Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />HEAT SOURCE <br />_ Electric �Gas _ Olher <br />CONTRACT PRICE OF WORK <br />MECHANICNL <br />NO. I 1YPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />as pipinc� <br />Water heater <br />Gas (ire�lace <br />Gas ra�go <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined tnis application and know lhe same to be true and correcl All provisions of laws and <br />ordinacas governing this type of wor4 will be complied wilh whelher speci(ied herein ur not. The granling of a permit does not presume <br />te c�ive aulhorily lo violate or car.cel lhe provision of any olher stale or local law rec�ulating construction or the periormance of <br />conslruction. That I am authorized by the owner of lhis property to peAorm lhe work (or which application is made a�d I comply wilh lhe <br />Slate Contraclors Law 18.27 RCW and 296200 WAC. <br />� �GK ��-C�-,--r` G' ���� � <br />Signalure of Owner/ContractodAuthorized Agent Dale <br />' /a <br />