Laserfiche WebLink
r <br />PE�rtMIT APPLICATIOt�i <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED ' <br />SITE ADDRESS /] v PARCEL TAX I.D. # <br />�(���� ��IOJ�IG�AG- I�O�� UnCG2�i - cX1'T - � <br />LOi N0. BLOCK TRACT (�� p �= <br />J � Qqn��Jo �nT� <br />I —�U <br />i Sl�� I�t'I <br />17�vfS10� �Z <br />PERMIT � <br />�0 � <br />� i3 , r°3z <br />�:sqiG�L,9/✓/) ��o/nes �✓�c. ?�, [3oX $'/3 LK, S7tUEN5 `/�25� <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />S��u�. �.,��,za�s �/zs•3s�-���� <br />CONTRACTOR �kt�ND ��IMCS .�r�• '�'�DRESS <br />CONTR.LICENSEA Lp��CLNZ OoIJL <br />USE OF BUILDING <br />Sr= 2 1�1� � <br />WORK DESCRIPTION <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />Backtlow praventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Eiectric � Gas _ Other <br />CITY2IP PHONE <br />IiZJ' � �� _ �'.l!� <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FOCTURE OR ITEM <br />A/C - air handling units ' <br />Forced air systems <br />Gas �iping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br />I hereby ceritify that I have read and eaamined this application and knaw the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stato or local law regulating constructlon 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 />�/ J <br />-Cv�.�� 2 g�OS <br />Signature of Owner/CentractorlAuthorzed Agent — at� �/ <br />�2 <br />