Laserfiche WebLink
SITE ADDRESS <br />�n io <br />LOT NO. <br />PERMiT APPLIC,ATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STR�ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE Af,CEPTED FROM 8 AM TO 4 PM <br />oYT N� <br />PARCEL TAX I.D. # pERM1T # <br />00 �ii 3ti,��o,zt�'o�� '.� (_>`jD7Uvl <br />TRACT OR SUBDIVISION # <br />�vrnen Huunesa ainur rnont .fZS <br />���.`%l f-An�i�.Y �. t. �� 5c-nz �d 3a9 AU� u,. �vc��:rr,- 93�0� 259-.zn�10 <br />TENANT NAME � CONTACT FOR PEF.MIi PHONE <br />E-MAIL <br />CONTRACTOR ADDRESS CINIZIP PHONE <br />/� RYN � � �V nh' Y� wc� � r / 3 0;� •/11AR i�,e pK. i��, F. .� GG <br />CONTR. LICENS[ p /!�f�ttiy/fL'��/r aj y'�I' l�' � <br />/jl;�Ati�•�c��� 09 9�a7i <br />USE OF BUILDING <br />WORK DESCRIPTION L�r�j�oc. � r�o .✓ <br />PLU�VIBIN3 <br />NO. I TYPE OF FIXTURE OR ITEM <br />=I Toilel <br />Balh�ub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dish�vasher <br />Clothes washer <br />Walcn c�ater <br />Sink (servicelbarhnoplelc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Flocr drain <br />Grease Irap <br />Roof drains <br />Olher <br />HEATSOURCE <br />Eleclric Gas Olher <br />CONTRACT PRICE OF WORK <br />y R c>c%U <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />W aler healer <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby cerilify that I have read and examined ihis applicalion and know the same to be true and correct. All provisions of laws and <br />ordinaces governing Ihic type o( work will be complied wilh whether specified herein or not. The granling of a permit does not presurre <br />to give aulhorily lo vlolale or cancel lh� provision o( any olher stale or local law regulaling con,lruclion or the performance of <br />conslrudion. Thal I am aulhorized by lhe owner o( lhis property to perform the work for which applicalion is made and I comply with �:he <br />State Contrar�lors La v 18.27 RCW ��nd 29�200 4VAC. <br />/ �-,v�,S�-'- :� �!�t�..,' S�6�� 9 <br />