Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everethva.org � � `a 6 � / <br />b <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADD ES� <br />" / �; ,�� <br />L 6AL LOT N0. BLOCK TRACT <br />DESC. <br />7�l7 � �/`� � <br />TENANTNAME <br />PARCEL TAX I.D. # <br />I CONTACT FOR PERMIT <br />! <br />� <br />CONTRACTOR ADDRESS CITY'21P <br />�ct�-�� S�'-�.UIC � �//�(� ��? 7.��t G�-� �i.� <br />ONTR. LICENSE # � �I� � �'—'" <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM1I <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />_[_, Kitchen sink 8 disposal <br />Dishwasher <br />_L Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backilow preventer <br />Urinal <br />Drinking Fountain <br />Floor dr�in <br />Grease trap <br />Roof drains <br />Other <br />� u�� � l <br />HEATSOURCE <br />Electric Gas Other <br /># <br />� <br />�2J��ZZ�— <br />PHONE <br />PHONE <br />3.�`'!- �� <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C—airhandling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />_ Woodstove <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 true and correct. All provisions of laws and <br />ordinaces govcrning this type of work will be complied wilh wnether specified herein or not. The granting of a permit does not presume <br />to give authonry to violate or cancel the provision of any olher stale or local law regulating r.onstruction or the peAormance of <br />construction. That I am authorized by the owner of this property to perform the �vork for which application is made and I comply with the <br />State Contrectors Law 1p.27 RCW and 296.200 WAC. � � <br />�� <br />