Laserfiche WebLink
SITE ADDRESS <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />�s <br />TENANTNAME <br />PERMIT APPLICATIUN <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 B AM TO 4 PM <br />BLOCK <br />CONTRACTOR SE�����5 /NC <br />y'y, f) AT• /lOn1E , <br />CONTR. LICENSE N �y��� .x. <br />._�—�d-- <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />� <br />Toilet <br />Balhlub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink 3 Aisposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (serviceNarlmop/elc.) <br />Backtlow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Ftool drains <br />Other <br />PARCEL TAX I.D. # <br />TRACT <br />p MiT# <br />�D(pD�-U�IZ <br />�2�p PHONE <br />ICONTACT FOR PERMIT <br />ADDRESS CITYIZIP <br />��e .�o�rH -�ao �n s� <br />HEATSOURCE <br />Electric _ Gas _ Other <br />NO. <br />a"°(�)•3�. s6 99 <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />rVC — air handling units <br />Forced air syslems <br />Gas piping <br />W aler healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Ur�it heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Olher <br />CIN OF EVERETT I.00AL SALES TAX CODE IS 7105 <br />I hereby ceritify thal I have read and examined this application and know the same to be lrue and correcL All provisions of laws and <br />ordinaces governing this lype of work will be complied with whether specified herein or nol. The pranling o( a permit does not presume <br />to give authonry lo violale or cancel the provision ot any olher state or local law regulaling conslruction or lhe pertormance of <br />construction. That I am authorized by the owner of this property to peAorm the work for which application is made and I comply with the <br />Siale Conlractors Law 18.27 RCW and 296200 WAC. <br />. _ a� z� 0� _ <br />