Laserfiche WebLink
ERIV�IT APPLICATI N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 4?_5-257-8810—FAX 425-257-8857—www.everetfua.org <br /> APPI,ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.if PBRMIT� <br /> lyol � E3Lc'�ooc.�coiou I �^o�ol-o,z� <br /> LEGA LOTNO.� � BLOCK TRACT <br /> DESC. <br /> ADD 21P PM t.�ZS� <br /> �F r.�+,,�w►,� �,� iq�a� �o��w. S�. ae� ►�.,�,°►e�3� te-to`iayd. <br /> 7lNANTNAM6 ' CONTACTFORCERMIT PHONE <br /> �F. 09�oPn+�u�- l.� P I �Mt�1 Cv�R.vAt1 �-}2S 37-� -v-toD <br /> � CANTRACTOR �'�OIJ���C., �nREss3Z2os CRY21P PMON! <br /> CONTRLICENSEM �,;;;��,��" �-�2r-�3'°� <br /> v�►���� c�cua� qa��g�,3 <br /> USE OF BUILDtNG HEAT SOURCE I CON7RACT PRICE OF WORK <br /> �A,JI..'�1F�(� I Y ElecMc _Gas_Other L�, /�/'�� 12 <br /> �iv <br /> WORK OC9CRIPT�ON <br /> ��T��c� �I�W ��,U�,� �r►�u�-T��,�,�w <br /> PLU ING M HAN) AL <br /> NO. TYPE OF FIXNRE OR IiLM NO. TYPE OF PpC!1JRE OR fTElll <br /> _, Toilet A/C—alrhandtingunib <br /> ` Bathtub ` Forcedairsystema <br /> , l.avatory(wash ba�in) ",. Gas plpinA <br /> _ Showor Waterhoater <br /> _ Kitchen sink 8,disposa� � Gas flreplacc <br /> __ Dlshwasher Ges range <br /> _ Clolhes wesher �+ Clothes Ory¢r <br /> weterhoeter � Rangehoo9 <br /> _ Sink(dervicalbarlmop/etc.) Exhaust fan <br /> , BaeMiow pravcnter Hee1 pump <br /> � Udnal � Unkheater <br /> � Drinkiny Founqin Boller <br /> � Floordraln � Rehigeral'an <br /> , Grease trap ,_ Woodstove <br /> Roof drains _, Other <br /> , Olher <br /> I <br /> CITY OF EVlRpTT LOCAI,SALES TAX CODE IS 7105 <br /> 1 Aereby cerltlfy that I have read antl examined fhic application and know the same to be true and coRect AII provt�ione of laws pnd <br /> orclinecea govoming thls typo ot work w;ll be cpmpllmd wtM vfiether epecHiW horoln or not.Tho gronUng of a perttUt d0as not pre�um� <br /> to qWe eutho to vlolata or cancel Ihe provisian oi any othQr sfete or lowl law reguletlny tonstructlon or the perfprm2n�e of <br /> conatruction al I am au o ed by the owner ot th(y property to perform the work tor which epplkatlon Ie mede and I aomply with the <br /> Steto Con rs�aw 1 CW and 298.200 WAC. <br /> .�..------ I (., 0 <br /> Slgna e o ner n aorlAutho zea gent ata <br /> �y <br /> \ ..\o�° <br /> o� � <br />