Laserfiche WebLink
r <br />FcRMIT APPLICATIvN <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 6 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # P RM( # �/ <br />H � 3�F l� k.lA.lk( LT�U F�-VD , oc�l(17 �� U6�GC� � J� �'�t � <br />LEGA LOT NO. BLOCK TRACT <br />DESC. (Q �� _ p_ � <br />OWNER ADDRESS CITY2IP PHONE <br />fl'�KK g��ucxN ZI3G� w, r�Wk«T� CNr u,�.uu. ZSY-?ZSo <br />TENANTNAME <br />Sl�rnct / o� Nar,2 <br />ICONTACT FOR PERMIT <br />�c (xz111��25Tz AI <br />CONTRACTOR �1�L` 1 <br />�Y G��1rtG� S��IG <br />CONTR. LICENSE # <br />USE OF BUILDING <br />, ;�,_.. • • <br />WORK DESCRIPTION <br />PHONE <br />`�ZS— 2)`1-7ZSb <br />ADDRESS CITY2IP PHONE <br />�OTC l2c�Q � Z,uic�(�(7� U.lA� N2J�- 7i y-I2�� <br />— HEAT SOURCE I CONTRACT PRICE OF WORK <br />1�C.)1�(� <br />Electric _ Gas Other ,�jS CGO '— <br />Got�lSTi2UGZCOFI. GF l� 2� X�i+4 �3L ��'J �l�t4ul� �yCc4ci�t . <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundiy lray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinkinc� Founlain <br />Fioor drain <br />Grease trap <br />Roo( drains <br />Olher <br />NO. � TYPE OF FIXTURE OR I7EM <br />A/C — air handling units <br />Forced air systems <br />Gas pipinc� <br />Water heater <br />Gas flreplace <br />Gas range <br />Clothes dryer <br />Ranc�e hood <br />Exhaust fan <br />Heat pump <br />Unil heater <br />Floiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br />I hereby ceritify thal I have read and examined this application and know the same to be lrue and correct. Ail provisions of laws and <br />ordinaces governing lhis type of work will be complied wilh whelher specified herein or not The grenting of a permit does not presume <br />to give authoriry lo violate or cancel the provision of any other slale or local law regulalinc� construction or the performance ot <br />conslruction. That I am aulhorized by the owner of this property lo perform the work for which appiicalion is made and I comply wilh lhe <br />S�ntraclo�baw 18.27, RCW and 296.200 WAC. <br />i/ <br />( <br />