Laserfiche WebLink
PLRMIT APPLICATKA <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �Ll // �� <br />FAX 425-257-8857 <br />425-257-8810 — — www.everettwa.org /� j <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT A TED <br />SITE ADDRESS n <br />9 100 y41_1bc5o6-> KoAt) <br />PARCEL TAX I.D. # <br />?k0q /i00 /oif 0o <br />IT <br />LEGA LOT NO. <br />BLOCK <br />TRACT � <br />DFSC. <br />OWNER ADDRESS CITYIZIP PHONE ti.;?s­Jyk_23,,_ <br />Cc�ivl/69tI c_P/17" 17/ev k�)'b Etta --rr &LA 9s Zo3 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITY[ZIP PHONE <br />5%N_4ES4 vim` Ncv Jf-77 - 4oW /1vi�-5 56?177zc,t-;A i-PIP zcc• �r4-t cy <br />CONTR. LICENSE # eC N L `I y.0 () E <br />USE OF BUILDING <br />HEAT SOURCE <br />bCONTRACT PRICE OF WORK <br />/P <br />Electric Gas Other <br />/ / <br />_ <br />WORK DESCRIPTION DF:�/b Al 44)b /N 5TAtL <br />/%I6,61ee- G/L/oL- ?re <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR REM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />AJC — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />I <br />' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I Have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified hereir. or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />Signature of Owneri"m a tor/Authonzed Agent Date <br />2 <br />/1 <br />