Laserfiche WebLink
PEr�rVIIT A►��'LIGATIQ�� <br />CITY OF EVERETT PERMIT SER�'ICES <br />3200 CEDAR STREET, =VER�TT, WA 98201 <br />� c:S��(' OGf <br />7UJb3/3 -O� (c <br />47.5-�57-8810 — FAX 425-257-8857 — www.everettwa.org �� `�v _ �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTEU <br />SITE AODRESS , <br />� W /' <br />LEGA� LOT NO. <br />TENANTNAME <br />CONTRACTOR/� <br />� �ur �Ci%�6c �w�: . <br />CONTR. LICENSE # <br />-�;��c2cr 9�'G:.% <br />USE OF BUILDING <br />WORK DESCRlPTION <br />PARCEL TAX I.D. # <br />2 " 60.3o/COG3J�0 <br />BLOCK TRACT <br />��'�J .�c ��,/.�c z � <br />ADDRESS <br />4�E �.�3��sh' �z. � <br />I CONTACT FOR ERMIT <br />I FERMIT <br />1 <br />� sl�" w,� <br />IT <br />9F'2�x1 ' <br />PHONE <br />ADDRESS , CITY2IP PHONE <br />/.✓f �c�h�Pl .�SLt'. �✓c�i��Fcc� ��•9����i� �,3 <br />HEA7SOURCE <br />Electric Gas Olher <br />G1e"��/%70:� F�r�c.r i'—a.� ..�sk�,�-T <br />NO. I TYPE OF FIXTUFE OR ITEM <br />rai�e� <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />BackFlaw prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease hap <br />Roof drains <br />Olher <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />W ater heater <br />Gas firealace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />i urit heater <br />L;o'ler <br />F;e� rigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby ceritify� that I have read and examined this applicalion and kno�v the same lo be true and correcL All provisions of laws and <br />ordinaces goveminy lhis type o( work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision o( any other state or local law regulating construction or the performance of <br />construction. That I am authorized by lhe owner of this property to perform the work (or which application is made and I comply with lhe <br />State Conti6etQts Law 18.27 RCW and 296.200 WAC. <br />ISignai <br />L�. <br />// <br />2 <br />