Laserfiche WebLink
PE1�tIliIIT APPLIC,4T10 <br />� CITY O� EVERETT PERMIT SERVI�ES 9`�y�D�/ <br />3200 CEDAR STREET, EVERETT, WA 98201 7 <br />('\ � � ( � 425-257-8810 - FAX 425-257-8857 - www.everethva.org n� ' Iv� � <br />1 ,7' �) �� 7 <br />� <br />APPLICATIONS EaRE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS �"�._i PARCEL 7!U( I.D. # PERMI'T/# <br />UUf.�,_ _ ./ ��.,,.1 /.�.�A ��E- ......,� .nnv F)7 u n/ln N /��! o / �� U� %- �'� <br />LOT N0. <br />SD�n <br />TENA�:T NAME <br />TRACT <br />�C' <br />CONTACT FOR PERMIT <br />FHONE <br />I�Te��+,a T Sta,� ,�o; � Y.�s � G fs -.S �/ k� <br />CONT.RACTOR ADORESS CITY/ZIP PHONE <br />CONTR .;cNSE# <br />Qu���c- <br />US': OF BUILDING <br />u �I <br />WORK DESC <br />, %�/ <br />NO. I <br />� <br />TYPE OF FIXTUFE OR ITEM <br />Toilet <br />B: �htub <br />Lavatory (wash b2sin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/elcJ <br />Bzckflow preve�i�er <br />Urinal <br />Drink�ng Founlain <br />Ficor drein <br />Grease trap <br />Roof draina <br />Other <br />HEATSOURCE <br />Electric �Gas _ Other <br />CONTRACT PRICE OF WORK <br />d�SD. DOD°J <br />, <br />�> �J�.� �� <br />�;�� a _��� �-�,� r��_ oi<l <br />ECHANICAL <br />NO. I NPE OF FIX7URE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />W ater he2ter <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Rangehood <br />Exhaust fan <br />Ff9at pump <br />Retrigereliqn <br />Woadstove ���. <br />Other <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS J�OP <br />I hereby cerilify thal I have read and examined this aoplicatior and know lhe same to br true and correct. All provisions of laws and <br />ordinaces governing this type of work wiil be comp!ied with whethe� specitied herein or noL The granting of a permit does not presume <br />�o yive authority to violata� or cancel the provision of any other slate or local I<�w regulating construc[ion or tho performance of <br />construction. That I am authorized by the owner of Ihis property to peiform the �vork for which applicacion is made and I comply wilh the <br />S,ate Contraclors Law 18.2 RCW an/d�'96.200 WAC. ��, <br />� � % <br />v <br />Slg wre of wnedCon actodA nzed Agent Dat � <br />fl�`� ���95 `�� <br />