Laserfiche WebLink
PEKMIT APPLICATION <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 />SITE ADDRESS <br />3c�o N��ifw si , L'V <br />LEGALt LOT NO. <br />DESC.r Z <br />L�rpTG saor,�� <br />TENANTNAME <br />APPLICATIONS ARE ACCEPTED FROM 8/lM TO 4 PM <br />BLOCK <br />i23 <br />i 2p I PARCEL � I.D. # '� v <br />w�. C�z� `/3�s 7� 30 ,�- v <br />TRACT <br />t�f7og coN�W( Rn <br />CONTACTFORPERMIT <br />PHONE <br />�A-TLr1A+.) V�h�xnr � �Nu �-i� 2oG -�74 -'Z-az.�}- <br />CONTRACTOR ADDRF.SS CITY2IP PHONE <br />S"C..`Nu ��YEK <br />CONTR. LICENSE p �'��V�\ <br />USE OF BUILDING <br />b__ �iN�l� �su,�l� � <br />.S+�+d71pk� Z.= S � P-'7�� <br />►`t7ea ca,�,�,.� �2� 5ti�,►�-� w�a. q�yl> ze�- �'18 - <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />I�Eleclric Gas _ Other � % �D . � <br />WORK DESCRIPTION <br />�� `) � A,-�/1 !,c_._. G / <br />l^ <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sick (serviceNar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXNRE OR ITEk: <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas firep�ace <br />Gas range <br />Clothes dryer <br />IZange hood <br />1=xhausl(an <br />lieal pump <br />Unit heater <br />Uoiler <br />Reirigeratio� <br />Woodslove <br />Other i ��,���a�,� g(�i4�tWA" <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify thal I have read and examined this application and know Ihe same ro be lrue and correcl All provisions of laws and <br />ordinaces governing this rype o( work H�ill be complied wilh whelher specified herein or noL The granling of a permil does not presume <br />to give aulhorily to violale or cancel lhe provision ot any olher state or local la�v regulating consWciion or (he performance of <br />construclion. Thal I am authorized by lhe owner of lhis property lo peAorm lhe work for which applicalion is made and I comply wilh lhe <br />Slate Con clors Law 18.27 CW and 296.200 WAC. <br />, � b . �:�1�hL. Zli`�IO% <br />Signature o( nedConVactor/Aul onzed Agent Date �� <br />� <br />