Laserfiche WebLink
SITE ADDRESS <br />'1%tL `� n� <br />LEGAL� LOTNO. <br />PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8657 - www.everettwa.org <br />il <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. # <br />1�.<�R -Jicl-�3>"4- -!r'�� <br />y-��"g% <br />��», A-n<��� �`(u�o� }6•rG (�u.� U,I�S-E. Ly•,�-., w ���r� w'a �!'r�31 r.��6%��b'—Sz,i S� <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />�ic�c��: -i �-vH�.� �T�:i�l 5G-• /��'CFt['(FCT �JC'�� 3�)1' ��Sl 1 <br />CONTRACTOR ADDRESS CIN21P PHONE <br />CONTR. LICENSE # <br />'JSE OF BUI ING <br />i_�� 7 S�k"F�11� al' <br />WORK DESCRIPTION <br />�L� 1 �'�_,��,�����;��:�r=j <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />_ Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />BackFlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Electnc _ Gas _ Other <br />�,-.� 4�Pirl(r� f�IL��-' <br />N0. I <br />CONTRACT PRICE OF WORK <br />� � 9�5��� - <br />ti E-� /" L. l=� �' � �� 1( l�t;� <br />TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heatpump <br />Unit heater <br />Boiler <br />Re(ngeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be irue and correct All provisions of laws and <br />ordinaces governing this rype of work will be complied with whether specified herein or noL The granting of a pemit 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. Thal I am authonced by the ownar of this property to perFortn the work for which application is made and I comply with the <br />Slale Contractcrs Law 1827 RCW and 296200 WAC. <br />Signature of OwnerlContracror/Authon:.ed Agent Date <br />