Laserfiche WebLink
C,�// <br />PERMIT APPLICATIUN �f�s=s��-��,« <br />CITY OF EVERETT PERMIT SERVICES ����r� -C��, <br />425 57o8810D FAX 425 257E885RE www e e$etOtwa.org � �G�"l �i� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />3 7� p� I BLOCK I TRACT <br />'�l � �wL <br />PARCEL TAX I.D. # <br />:� +�i.� 6ao <br />�It <br />PERMIT� � <br />� -�o�-v�� <br />2a �l't.5 -z �z ' <br />��.`7G✓4 9�'\t.GNAG� \O�(aj`'�T�L� S�iI.� �����R7ZfJ� �'�C�� <br />TENANT NM9E <br />t CONTACT FOR PERMIT PHONE <br />��� �w NF.-c�- S�rt� <br />CONTRACTOR <br />CONTR. LICENSE N � <br />USE OF BUILDIN <br />�,^�t�e •�a- <br />�es .. <br />WORKDESCRIPTION {ipii: <br />ADDRESS <br />HEA7SOURCE <br />� Eleclric _ Gas _ Olher <br />C�7Y21p PHONE <br />CONTRACT PRICE OF WORK <br />r•, -�nl� �t-Se.wter��' 1 ��✓nc�c �a� Kc�l.-�10�'1 <br />_ �A�Co� CJ�c -.a- / <br />NO. I TYP[ OF FIXTURE OR ITEM <br />0 <br />Toilel <br />Dathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchea sink & disposal <br />Dishwasher <br />Clolhes washer <br />W aler healer <br />Sink (scrvicelbadmop/cic.) <br />Back(low preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olher _ <br />NO. I NPE OF FIXTURF OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Cblhes dryer <br />Ranye hood <br />Exhaustfan <br />Heat pump <br />Unil heater <br />Boiler <br />Re(riaeralion <br />Woodslove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerility lhal I have read and examined lhis application and know the same lo be true and correcl. All provisions ot laws and <br />ordinaces govemin9 this lype of work will be complied wilh whelher speci(ied herein or not. The granling ot a permil does not presume <br />to give aulhority to violate or cancel the provision of any other state or local law regulating construclion or the per(ormance of <br />construcli p. hat I am a horized by the owner o( this property lo pedorm the work (or which application is made and I compty with lhe <br />Stale Co �r c rs w tff 7 RCW and 296200 WAC. <br />. �.�./�. .� � <br />Sior.alure uf OwnedCon clorl orized Agent Date Z <br />