Laserfiche WebLink
�cRMIT APPLICATIuN <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPUCATIONS ARE ACCEPTED FROM B AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />aa►4 rn�� <br />TENAN'f NAME <br />�� i <br />PARCEL TAX I.D. # <br />GU`i3a�yl'-I( <br />TRA T <br />Iq-i o F Fve�e� <br />3NTACT FOR PERMIT <br />enne� C��Yis���sc�i <br />��i s �. 3 a <br />ie 9$3�u�,,,,�o-3�' �CtiCI -a96 � <br />4��� 4�s-33�-679L <br />36o"-�S �- or-I 6B h w� <br />�5- a3$- lr�l c* I I <br />CONTRACTOR I���n CUh�'�C) i01� ADDRESS CITY2IP PHONE <br />��,o �� �y�,.;,[. NF ti11cnC���lk' 9��70 36�� 65/-oq6Z <br />CONTR. LICENSE # UY �S— ��O -�� � <br />KmcoN � � �a�l oa <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />S�I_/�P �QNilv� ����i�� _Electric �Gas_Olher �-' �/�,' • t��� <br />i( i� <br />WORK DESCRIP710N <br />1�i��1C� <br />�i9 <br />l���l/ 1��a �f'� <br />��ouy� <br />°.�' <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbarlmop/etc.) <br />BackOow prevenler <br />Urinal <br />Drinking Fountain <br />Flocr drain <br />Grease lrap <br />Roat drains <br />Other <br />a s�"oc•� S�nb� Faw�l� \�'sidehre <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Ga� pipii,9 <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion Fv � � <br />Woodslove <br />Other <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify lhal I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces c�overning this lype of work will be complied with whether speci ied herein or noL The granling of a permil does not presume <br />to give aulhority lo violale or cancel the provision of any other state or local law regulating consWction or lhe perfortnance c( <br />construction. Thal I am authorized by the owner of ihis property lo peAomi lhe work for which apolication is made and I comaly with lhe <br />Slate Conlraclbrs Law 18,27 RCW a/�a 296.200 WAC. <br />.�yloS <br />'l� <br />