Laserfiche WebLink
SITE ADDRESS <br />LOT NO. <br />NAME <br />� Ccarr,;C� <br />UCENSE # <br />USE OF BUILDING <br />PERMIT APPLICATIOrI <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 [ p�� 3�� <br />I PARCEL TAX I.D. p I P�RMI7 # <br />BLOCK TRACT OR SUBDIVISION # <br />L�C.;�l_ i nr.��cr, � <br />ADDRESS � �� <br />�,, y�`/6 /��� f� <br />CONTACT FOR PERMIT <br />r��;-y <br />co,xrrc� ConC�.,o;{;a <br />ADDRESS <br />13��1 �P/ �c. <br />arn �1 � �/a�j� <br />I HEATSOURCE <br />u �� - i,p. <br />WORKDESCRIP":ION ��Qt�G� <br />PHONE <br />S+�h�M �s� wA <br />V/ (1��"/ Q <br />� Eleclric __ Gas _ Other <br />q�d REplaer,.5 0� f�Eeics <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />W ater heater <br />Sink (serviceNarlmop/elc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other <br />� <br />'`d70 ^�lf7 <br />y.�s- ��o -�;� <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piNing <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify Ihal I have read and examined this application and kno�v the same ro be true and correcL All provisions of laws and <br />ordinaces govemin� ihis type ol work will be complied �vith whelher specified herein or not. The granting o( a permit does nol presume <br />lo give authority lo violale or c2ncel the provision o( any other state or Iocal law regulaling construction or the performance of <br />construction. Thal I am authorize�f$y the owner of this property to perform Ihe work (or which application is made and I comply with the <br />State Cont�clors Lav+ 18.27 RC a��6.200 WAC. <br />�l%/�`%���� Q-/5��� <br />��� <br />