Laserfiche WebLink
SITE ADDRESS <br />Dli /-�ii> rE� � <br />LEGAL LOT ��0. <br />DESC. <br />OWNER <br />lG/f ' �'i Z <br />TENANTNAME <br />�/�7 <br />P�RMIT APPLICATI(��� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR.EET, EVERETT, WA 9820'I <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. # <br />�O �"� %9�/n l no/�e <br />TRACT OR SUBDI�ISION # <br />/ � ���k� /%;�,� �✓J n � <br />ADDRESS CIT1 <br />Dl� �G� /-�+,-G/,��' J v���� <br />I CONTACT FOR PERMIT <br />N �/P%%liJl,J' J� ��j��=�" j' <br />CONTR. LICENSE �/L, I/ � <br />��7C. <br />USE OF BUI! DING <br />/ <br />�,1 %- �- C�� 7�. <br />-3 -� <br />'ERMIT # <br />_ I�'�- � <br />9,p,?oi 5 ��- �1'9 .Z.3 �s' <br />PHONE ZT S-v -d7� <br />�C��C ��U,��CIfO�'1 E-MAIL <br />�113 /s l ���i'J%..._.. <br />S/�%y'om;✓h; l•✓i� 9�f'�? 9! <br />HEATSOURCE <br />_ C-lectric � Gas _ Olher <br />�1.� ���' J7Jl <br />CONTRACT PRICE OF WORK <br />W RK DESCRIPTION <br />� �>r �i=r oJa� /'��✓rn�;����J �'v/�Nr���Gvr�/IINI- <br />�% �Qim�,<<c /�J/✓�C�l✓ /1�%�'q/dl�� </�.-'� 1 5i?�� �,uiiJ,!'/ ,yY/.i9r',�?��`� <br />/i ,Qi;�Jr, �.i �Gr< �-� � �/,e� v� rIz y ,�,-•�7 irn� �l�i,'?'.1 <br />� <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilel /{�Em.:✓ � <br />BalhWb <br />Lavalory (wash basin)�",r�,.'✓� <br />Shower <br />Kilch�en sink 8 diseosal/{�'�/�7.'✓'r �'/ir!'�C� <br />Dishwasher ��i17�1�'r!�'"% /i�-F�!�« <br />Clothes washer <br />Water {iealer <br />Sink (servicelbadmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other <br />NO. I TYPE OF FI;(TURE OR ITEM <br />L_ <br />� <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />W ater heater <br />Gas fireplace <br />Gas range <br />Cloqies dryer <br />Rangn hood <br />Exhaustfan <br />Hea� pump <br />Uni; heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Olher <br />CITY OF EVERET7 LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify lha� I have read 2nd examined lhis application and know the same to be Uue and correcL All provisions of laws and <br />ordinaces c�overning ihis lype of work will be complied wilh �vhelher,peci(ied herein or not. The granting o( a permil does not presume <br />to give aulhorily to violale or cancel the provision of any olher slate or local law regulaling covslruclion or the performance of <br />conslruclion. That I am aulhorized by Ihe owner of this properly lo pedorm ihe wotk for which application is made and I comply with ihe <br />Slale Conlr2ctors Lmv 78.27 RCW and 296.200 WAC. <br />� ---- --�----- --- <br />