Laserfiche WebLink
SITE .4DDRESS <br />3� S� C�', i"l� <br />LEGA LOT MO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, E`✓ERETT, WA 982U1 <br />•'25-257-8810 — FAX 425-� 57-8857 — www.everettwa.org <br />APPL.ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �,.,� ..� jj <br />PARCEL TAX I.D. tl PERMIT # <br />(-r�o �� I ��. . /1'1 ��1D7- O2� <br />T eLUCK TRACT OR SUBDIVISION # <br />�l.Ji ��1\lll1 `,��<<�� ✓J I ") `L �h�L�J� � I f0 �/IYG� ��'ioG11 It,���_/ <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />, `IJ-5��23•-`l'7�I � <br />S: ��i. �. CC����k �.•oo��o��� E•MAIL <br />ADDR P <br />�-ff�R,r�,l�l�• H<<,�ir„�'% a-c�,o��,.,� _n,�. 3s�s °i97� nr. S�. Lk.s-r�,.��5 yz.s-33��-�9ca <br />CONTR. UCCNSE # J �I 515 � <br />USE OF BUILDING <br />;;�.��� r-�...,,�r <br />; . . : A � .,. � <br />WORK DESCRIPTION <br />� <br />�C'�'��QLI �til.S��ILI�I <br />J <br />HEAT SOURCE <br />_ Eleclric X Gas _ Other <br />U 1 I ���� �� 41Ai C <br />(,� ���\ }�� �� ���5 f�"v'��=��GC <br />NO. I TYPE OP FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mople�c.) <br />Backtiow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ _ <br />C(L��'� .� «s <br />�i,C( C(c c f✓ i c <br />(1'G.�I t. I'ICs,-f �V <br />CONTRACT PRICE OF woHK <br />� soc.c `=, <br />c� �,1� <<- h E�, l < <.� <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Cblhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />I hereby certify that I have read and examined this application and know lhe same to be true and corred. All provisions ot laws and <br />ordinances governing this type of work will be complied wilh whether specified herein or not. The granting of a pertnil does not presume <br />to give authority lo violale or cancel the provision of any olher state or local law regulating construction or the performance ot <br />construction. That I am aulhorized by the owner oi this property to perform the work for which application is made and I wmply with the <br />State Contractors Law 18.27 RCW and 296200 WAC. <br />Signature of OwnedContractodAuthorized Agent Dale <br />