Laserfiche WebLink
r <br />PEk�VIIT APPLICATION ,� < ' <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 n/' 1 _�, �/ <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � KJ i�v � <br />APPLICATIONS ARE AG :E8%ED FRO�VI 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS ��, � / � <br />LOT NO. <br />DESC <br />BLOCK <br />OGJt�iE.H LU <br />TRACT <br />�—DU <br />- �� µ4 <br />�LIT� C.t.rn��ti r� �}.,-c,cn��i SiUG i7i3 7K'�vL NE }�� <v�'1/c. �$�7b <br />TENANT NAME I CONTACT FOR PERMIT pHONE <br />/�ini��e„��v /v� /n�nrv�r i 70�'S-��/- 7ia� /� <br />CONTRACTOR ADDRESS CITY2IP PHONEy��3� L�}�G <br />�ur� ��_����.v,�y�-���.ST.�� 7��3 ���<,�,_= �.�ysti�;��� 9s.���, "' <br />CONTR. LICENSE # <br />USE OF BUILDING <br />1U5�C%t.uTin.I � V �%PL��C <br />WORK DESCRIPTION <br />'Jr "; " ���JS%r, i� %. n..� c7/' <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kilchan sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Laundry lray <br />Sink (service/badmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roo( drains <br />Olher��. /,�./.} <br />HEAT SOURCE <br />� [lectric _ Gas <br />Other <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXiURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas firoplace <br />Gas range <br />Clothes dryer <br />Qange hood <br />Exhaust fan <br />Heal pump <br />Unil haaler <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br />I hereby ceriti(y that I have read and examined lhis applicalon and know� the same to be true and correcl. All provisions of laws and <br />ordinaces governing this lype of work will be complied with whether specified h�:rein �r not. The granting ot a pertnil does not {,resume <br />to give authoriry to vioiate or cancel the provision of any other state or local law r^.c�ulaling consWc6on or the perfortnance o! <br />conslruction. That I am authorized by the owr,er of this propeRy to per(orm the work for which application is made and I comply with the <br />State Contrar �rs La��1.8.�7 RCyW a�Pd 286.200 WAC. <br />.-.,/�' `_. i / L. _. i/ •l / /�- <br />I /� <br />,Swos �ss 9�203 <br />