Laserfiche WebLink
P�RMIT APPLICATIO��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 />� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NO? ACCEPTED <br />SITE ADDRESS <br />� <br />LOT NO. <br />BLOCK <br />3 ouo �-�� <br />���Qs f-�r �'��ls�►� <br />TENANT NAME <br />PARCEL TAX I.D. i� <br />OC��;�_3(. 000 D <br />�/��Stn/ <br />CpN'fqCT FOR PERMIT <br />- av <br />�j rs 2 <br />� 11i� MR,S 1�1 I�S '�.-�1 <br /># <br />a^. 5' •� `,— Of.:� <' <br />CONTRACTOR / , ADDRESS � CITY2P � PHONE �^�. .�.z <br />/`��ih I<F il ��! '� ";'� a lt��.�ifr.,c, f3/l� �f�%r ��i� �,u. � �,_�i? <br />CONTR. LICENSE #� } �.` ", , L n � W O J tl W N \ ����`` <br />r �, �; Y � l� lOR � <br />�,���. ��� r ��� :� <br />-���- � �2 ___ <br />USE OF BUILDING <br />��S ����t l0.\ <br />HEATSOURCE <br />_ Electric k Gan _ Other <br />CONTRACTpRICE OF WORK <br />mov�n� �17,�50 <br />�iJAS'<- A2'I�JL <br />WOhK DESCRIPTION ---- i___ <br />� . .._ � ,. ��r i. � � � , <br />� � ', r, �,�, r� ', y �� _ . f, l,-� r� !' , ) , t.'-'.� <br />�. � � ,> t'� � . r . � , <br />r1�T�0Li5'� �V J�. 1'�'IOV�.L U��NS �i01 I'I�t✓� �11 L�'G� O%� .SIPC''`'-i—C:Il..fl^1 <br />` PLUMBING MECHANICAi <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicel6ar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. � 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 />Gas renge <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAI SALES SAX CODE IS 1105 <br />�11UV `� <br />I hereby ceriti(y that I have read and examined lhis application and know 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 lo violate or cancel the provision of any other state or local iaw regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for �•�hich application is made and I comply with the <br />State Contractqrs Law 18.27 RC'N and 296. 0 WAC. <br />//�, <br />_ ��..0�....,l�+ � 1-�1G.-. _ j���C�L� <br />natureof wnedContractor/Authonzed gent p A I/ <br />�, � �ara <br />2 <br />