Laserfiche WebLink
PERMIT APPLICATION <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 B AM TO 4 PM <br />SITE ADDRESS Ih `Dauc�"� pw: <br />PARCEL TAX I.D. # <br />_PERMI��Tyy# <br />L[GA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION If/ <br />. <br />U[SCI?., I <br />IitLL.- hOJi-T ivy/ <br />OWNER ADDRESS CITY/LP PHONE <br />p cE GLgRIC �'i;"- rlcL7ovGnL�/w& G-vcRG•-7-, 45'Zul qZS 252''76/� <br />r�l , <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE JLS -2S 2-'76 15 <br />�An�G. <br />`, r,��e l'1 E-MAIL <br />I <br />-MNTRACTOR /l1ic. G/9��JAlL`LL AD sY.r%GCITZIP P.HONEYay-Sso_+/3Lc <br />lyvm����N <br />CONTR. LICENSE <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />('7 AR.?((„i- <br />_Electric Gas Other w <br />I <br />WORK DESCRIPTION <br />o ,Non- u.✓ $443 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />-Y <br />Toilet <br />— <br />A/C -air handling units <br />-77 <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />— <br />Water heater <br />_ <br />Kitchen sink &disposal <br />Gas fireplace <br />Dishwasher <br />_ <br />range <br />_ <br />Clothes washer <br />_Gas <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />— <br />Sink (service/bar/mop/etc.) <br />-- <br />Exhaust fan <br />Backflow preventer <br />� <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />- <br />Grease trap <br />_Refrigeration <br />Woodstove <br />Roof drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances 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 to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Stale Contractors Law 18.27 RCW and 296.200 WAC. <br />Signature of Owner/Contractor/Authorizetl Agent Date <br />