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9523 HOLLY DR 2018-01-02 MF Import
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9523 HOLLY DR 2018-01-02 MF Import
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Last modified
2/15/2022 2:57:42 PM
Creation date
2/18/2017 12:53:52 PM
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Address Document
Street Name
HOLLY DR
Street Number
9523
Imported From Microfiche
Yes
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PERMIT APPLICATIuN \'4'AeeM <br />CITY Or EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />ql:�93 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />_ 1 oI1 <br />CIQIdC <br />004p0'6o00000-700 <br />71 <br />LEGAL LOTNO. <br />BLOCK <br />TRACTOR SUBDIVISION# <br />DESC. 7 <br />Q60 D-00 <br />A L+e2S ay%ve <br />OWNER <br />ADDRESS CITYIZIP PHOHE42,.; w*-Z07Z <br />S-ruem Sakti <br />K An/Dsyeek CeAsf. LLC 4315- s- (2Ormmc aJ -SAcLL yg®12 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />I <br />M IA <br />I STEUELRNOSYEQKt� 11ti q • C <br />S7EUE <br />EMAIL <br />O TRACTOR <br />ADDRESS CITYIZIP PHONE <br />CONTR. LICENSE # ST15VESL 1p S$ KQ <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />S-zz <br />—Electric 4Gas Other <br />I <br />I <br />WORK DESCRIPTION <br />F-avR S10911f- ;CAVn;)y �eslcIeoce <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet 11 1 <br />A/C - air handling units <br />Bathtub 1 I <br />�- <br />Forced air systems <br />Lavatory (wash basin) I1j <br />� <br />Gas piping <br />Shower <br />_ I <br />Water heater <br />Kitchen sink & disposal <br />I <br />Gas fireplace <br />I <br />Dishwasher <br />_L <br />Gas range <br />I <br />Clothes washer <br />Clothes dryer <br />Water heater <br />J- <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />4 <br />Exhaust fan 11 r I <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give aulhodly to violate or cancel the provision of any other slate or local law regulating construction or the performance of <br />construction. t 1 am a rize byhe owner of this property to perform the work for which application Is made and I comply with the <br />Stale Contr c Is L R <br />Wad 296.200 WAC. <br />Z64" <br />0 /G <br />Sig r f n onlraclor/Aul onzed Age it Date l�� <br />
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