Laserfiche WebLink
PrRMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />LOT h0. I BLOCK <br />i� l�, ��{�v. Vi�..Lzo..��H, <br />TENANTNAME <br />CONTRACTOR <br />CONTR. LICENSE # '�� �� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />noys �S- �-b <br />TRACT <br />3> �� C. �.._.�J /1 �z <br />I CONTACT FOR PERMIT <br />)--�'/h�iS� W/c�� <br />ItiTO�"'1=� ��I�l�h�/ <br />� ,. <br />� , � l �., �. „-,� <br />NO. I TYPE OF FIXTURE OR ITEM <br />� 'f Toilel <br />�. Balhtub <br />� Lavatory (wash basin) <br />Shower <br />1�7 Kilchen sink & disposal <br />L Dishwasher <br />,� Clolhes washer <br />Waler heater <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />'01 <br />�VtiG(l, �/, <br />ADDRESS CITY2IP <br />HEATSOURCE I <br />_ Electric � Gas _ Other <br />PERMIT # <br />� (p0/ —Oa�-. <br />PNONE /��7_���.. <br />7 <br />9t��3b' �7�Z <br />PHONE <br />����� <br />PHONE <br />CONTRACT PRICE OF WORK <br />7.3 5�3� <br />�ew.�r �✓�'' � .7�l�h'�Z� T�e.'r .JC�C<"-s- ��. GGs�.�.�{. <br />. p"��,;i�. i.�'�:� 6'. �o i�e rd�'�•,^eC9 bc"' <br />/ nC, <br />NO. I TYPE OF FU(TURE OR ITEM <br />A/C — air hand�ing unils <br />Forced air systems <br />Gas piping �� � r� <br />Walerheater ` <br />Gas Tireplace / <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Bailer <br />Refrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br />ordinaces c�overning lhis lype ot work will be complied wilh whether specified herein or not. The granting o( a permit does not presume <br />to give authority to violate or cancel lhe provision ot any olher stale or �ocai law regulating conslruclion or the performance of <br />construction. Thal I am authorized by the owner of lhis property lo perform the work (or which applicalion is made arid I comply with the <br />Stale Contractors Law 18,27 RCW and 296.200 WAC. <br />� � ' 1���-� L a� 4S <br />Signature o( OwnedConlractor/Aulhon gent ' Dale �/�� <br />