Laserfiche WebLink
P�Ri�lIT 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 8 AM TO 4 PM <br />SITE ADDRESS eZ ��� l�: j�14 K� <br />r=JerE� c..��l� �?S <br />LOT NO. BLOCK <br /><� /� O/.'L PARCEL TAX I.D. # <br />�v� v��li7Uc���'�'�/�� <br />T )Al,) � .� �� � �/ l3� � � .(�'�- S <br />PERMIT # <br />CG7 0 & - OG �� <br />�� <br />`'�/ <br />c cy [ I <br />OWNER ADDRE55 CITY2IP PHONE U QS-737�p��i <br />' u�< �� `��c�,�-�� 34�7 1«orn�� AVe i�v�reN-48�1 <br />TEN�INT NAME CONTAi�OR PERMIT PHONE <br />1 uz�- 42.�- �t71 <br />CONTRACTOR ADDRESS .� CITYlZIP PHONE L�ZI�`�l,j—%IIi <br />S`C (��l_� 1�i�_ Elor�cs f I 31-�-�5 Av� SL�- � v�rEfr-�S�ds <br />CONTR.LICENSE# ���\n �;/r��,',`V� <br />ll <br />USE OF BUILDING <br />WORK DESCRIPTION <br />1Ui, w H�P"tr <br />NO. I TYPE OF FIXTURE OR ITEM <br />',` Toilel 11 1 � � <br />:',_ Balhtub �� � <br />� Lavatory (wash basin) �� �� 1\ 1 <br />L Shower i � <br />I Kilchen sink & disposal � <br />( Dishwasher t <br />� Clothes washer <br />L Waterheator <br />Sink (s^rvice/badmop/elc.) <br />� Backflo�. prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Electric �Gas _ Other <br />�UNST <br />NO. I <br />0 <br />e <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas pipiny <br />Waler heater � <br />Gas fireplace 1 I <br />Gas ranc�e <br />Clothes dryer <br />Rangc hood <br />Exhausl fan � 1 t 11� 1 <br />Heat pump <br />Unit hoaler <br />Bailer <br />Refrigeretion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined lhis application and know lhe same to bo We and correct. All provislons of laws and <br />ordinaces goveming this lype of work will be complied with whelher specified herein or not. The granling of a permit does not presume <br />to give aulhoriry to violale or cancel lhe provision of any other slate or Iocal law regulaling consWclion or the performance of <br />conslruction. That I am authorized by lhe owner of lhis property lo pedonn the work for which application is made and I comply wilh the <br />State Contractors LaW 18.27 RCW and 296.200 WAC. ,_ <br />• — r= <br />U <br />