Laserfiche WebLink
.� -- <br />P�RMIT APPLICATIC�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRF.ET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-25?-8857 — www.everettwa.org <br />�a -�f-oy <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />"�, � � �� �� C � <br />LEGAL LOT N0. OLOCK <br />�,y ,�- <br />TENANTNAME <br />PARCEL TAX I.D. # <br />TRACT <br />/U 7 ���� - �vPl�' <br />FOR PERMIT <br />P RMIT # <br />U/��� �Dj <br />'lZIP PHONE <br />��x—�'L�Z <br />PHONE <br />���i!"1 I <br />CONTRACTOR ADDRESS CITYIZIP <br />�/�li'�'-5 S��Z vCE �i�i /� �, f// i!�o �rP� r�-v� <br />CONTR. LICENSE X <br />Iii'.`i/V�f�/!o� V � '�� ..iJ�� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />ND. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />I BaqiWb <br />� Lavatory (wash basin) <br />Shower <br />/ Kitchen sink & disposal <br />Dishwasher <br />L_ Clothes washer <br />Laundry tray <br />Sink (servicelbar/mooietc.) <br />Backtlow preventer <br />Urinal <br />Dnnking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />� Olher <br />HEATSOURCE <br />_ Electric _ Gas , Other <br />PHONE <br />Ls � -z5'�� <br />CONTRF.CT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITE��t <br />A/C — air handliny unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplaco <br />� Gas range <br />Cloihes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Und heater <br />_ Boiler <br />Retrigeraticn <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby cerilify that I have read and examined this application and know the same tr� be true and co«ect. All provisions of laws and <br />ordinaces goveming this rype of work will be complied wilh wnethe• specified herein or not. The granting of a permil does not presume <br />to r,ive authority to wolate or cancel the provision of 2ny other state or local law regulating construction or the performance ot <br />construction. That I am authorized by lhe owner of th-= property to perform the work, for which application is made ana I comFdy with tne <br />State Contractors Law 18.27 RC4V and 29620G'�V.;C. <br />ot <br />Z-i5 -v / <br />n�m <br />