Laserfiche WebLink
ADARESS <br />LOT NO. <br />NAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICE� <br />3:!00 CEDAR STREEf, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-F3857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCH <br />Fi�om epvt/ner <br />CONTR. LICENSE Y . <br />USE OF BUILDING <br />PARCEL TA% 1.0. M <br />G�$"OShO�'oo <br />TRACT OR SUBDNISION N <br />/J?r�p/e ,�ei �ih�'.s <br />�—�S �— <br />/%%cairr�G�✓t� �YP. <br />CONTACT FOR PERMIT <br />C�P,r�� , �u c��r�- �Sp � <br />.S.�m� <br />HEATSOURCE <br />� E�ectric _ Gas _ Other <br />WORKDE3CRIPTIONJ� /_ ,���C�- � <br />2ea�tr ��� 0 <br />,c9�.�.� � -� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalMub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/barlmop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor draln <br />Grease trap <br />Roof drains <br />Olher <br />PER TA <br />lY�'�-�1� <br />;tt �Ig2o3 �25 3> <br />��� <br />��=3/'1-91� <br />CONTRACT PRICE OF WORK <br />C � ► <br />NO. I TYPF.OF FIkTUkE OR ITEM <br />A/C — eir hantlling units <br />Forced air systems <br />Ges piping <br />Water heater <br />Gas fireplace <br />Gas range ��n� <br />r,lothes dryer �L`�, � �� <br />Range hood '�,� � � �I� <br />E#�ausl fan �,�' Q �Q� <br />Heat pump " �� ��% i , <br />Unit healer � - � �,"� /� <br />Boiler / . � �'� <br />Retrigeration �� �, <br />Woodstove � ' <br />Other � �) <br />CITY OF EVERETT LOCAL SALES 7AX COOE IS 3105 <br />I hereby certify lhat I have read and exeminetl this application antl know 1he same to be We end corced. All provisions of laws and <br />orCtnances goveming this type of worY, will be compiied with whether specified herein or not. The granting of a pertnrt does not presume <br />to give authority to �9olate or cancel ihe provision of any atherstate or local law regulating wnsWclion orthe pedormance of <br />conslrudion. T�at I am authorized by tne owner of Ihls pmperty to pe�tertn the work torwhich applicetion is made and I wmplywith tho <br />State Cont/r�clors Law 18.27 R"W and 98.200 WAC. <br />i�74�ey/�'���.C,Le/l,�i/ v������ <br />Signature of OwnerlConlracroriAuthorized Agent Date �� <br />lL <br />