Laserfiche WebLink
� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, [VERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wvnv.everettwa.org <br />APPt,ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SfI�EI A�DDRESS <br />I l.o <br />IEGA LOTNO. BL CF <br />D[SC. <br />OWNER <br />Stir�l �m.c�� <br />�Naur e <br />NTRACTO ��� <br />� � <br />CON7R I,tCENBE e <br />gC t.,r.,r,,'�0. <br />USE OF BUIL6ING <br />�� � <br />WORK SCRIPTION <br />I E���I O�;c�l-�ss <br />NO. I TVPE OF FIX'R1RE OR ITLM <br />Tol Ict <br />Halhh.b <br />Lnvatory (wo3h bas�n) <br />Shot+�xr <br />K�tcho^ aink 8 disposal <br />Dishirasher <br />Clo,hc:. weshnr <br />Wa�r heater <br />S!nk (scrvi�rbadmory'CtC.) <br />Backflow ptevt+nter <br />Unnal <br />Drinking Fourtpin <br />Floor tlrmn <br />Grcose trap <br />Rcot dreins <br />Other <br />PARCE� TAX I.D. d <br />7RAcr OR SuBOIVISiON R <br />I- corrracT roR rearNrr — <br />.�� � � ���� <br />HFJ1T SOl1RCE <br />�Eledric _ Gas _ Othc� <br />�a-a- ��'�'`-� <br />PERMR # <br />?01 11�1L(Ol-OS� <br />PHONE <br />PHONE ' p���g o`o <br />��1-i�-L .....�Olc c���' �0 C�cm <br />� Elt� 6 <br />ONTRACT PRICE Of WOiiK <br />`�a�oo <br />N0. I T7PE OF FIXTURE UR REM <br />NG — air handling units <br />Forced air systems <br />Ga� piping <br />Watcr neater <br />Ge5 fifC+pI�CC <br />Gas ronge <br />Clatlies dryr.r <br />RnngehanA <br />Exhaustfan <br />Heat pump <br />Unit hd2ler <br />BOIIBf <br />Rcfridgr�don <br />Woodslow <br />Othar <br />CITY OF E1/ERCTT LOCAL SAI.FS SAX CODE IS 3106 <br />I hereby certify thnt I hnve ruod and nxnmipctiJ thl, epplicatlon and know thB san�o lo ba We and wrte�t All provisions of Isws and <br />orcfinances qoveming this rype o1 wadc �II be complied with whethnr specified herein or nnt The grentireg o(a pem,it does not pregumy <br />fn giVB dUlhOfify i0 V101ate or ptnc9l thc provision o( a�y othor sta4, or loc;d Inw ro��latlng eor,oWction or thc+ pcdortnpr.ce of <br />cons�dion. That I am authori d by Ihu a.mer ot this pmperry to partortn Iha work for whlch oppirc�tlon is made and I comply wilh Ne <br />Statc on!rpdors Lcw 10.2� (2�W �nd 2�T.00 WAC. r � <br />